The Current Use of Impella 2.5 in Acute Myocardial Infarction Complicated by Cardiogenic Shock: Results from the USpella Registry
WILLIAM W. O ’NEILL, THEODORE SCHREIBER, DAVID H. W. WOHNS, CHARANJIT RIHAL, SRIHARI S. NAIDU, ANDREW B. CIVITELLO, SIMON R. DIXON, JOSEPH M. MASSARO, BRIJESHWAR MAINI, E. MAGNUS OHMAN
Abstract
Prompt revascularization with percutaneous coronary intervention (PCI) has significantly reduced the incidence of cardiogenic shock (CS) and improved survival in the setting of acute myocardial infarction (AMI).1,2 However, when it occurs, CS remains a highly fatal complication following an AMI,3 despite aggressive revascularization and other adjunctive therapies.3,4 Percutaneous ventricular assist devices (pVADs) have been shown to provide superior hemodynamic support compared to intraaortic balloon pump (IABP) counterpulsation.4,5 In light of the recently reported studies that have failed to show a hemodynamicorsurvivalbenefitofIABPinthesetting ofpost‐AMICS,6–10physiciansmightadoptareflexive strategytousepVADsinthissettingmoreoften.While prospective randomized and adequately powered clinicaltrialsremainwarrantedtoevaluatethepotential benefits of these new devices, real‐world observational data can be useful to provide clinical insights on their use in daily routine practice. In the present study, we sought to evaluate the current use of Impella 2.5 in patients with confirmed CS complicating an AMI undergoing PCI. In particular, we were interested in evaluating the outcomes of patients who received hemodynamic support with Impella 2.5 (Abiomed, Inc., Danvers, MA, USA), prior to PCI versus those who received Impella 2.5 after PCI.
