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Updated: Feb 14, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

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Mortality in patients with cardiogenic shock treated with the Impella CP microaxial pump for isolated left

Jan-Thorben Sieweke1, Dominik Berliner1, Jörn Tongers1

  • 1Cardiac Arrest Centre and Advanced Heart Failure Unit, Department of Cardiology and Angiology, Hannover Medical School, Germany.

European Heart Journal. Acute Cardiovascular Care
|February 7, 2018
PubMed

Insights

Early hemodynamic support with Impella CP in cardiogenic shock shows promising results, with lower mortality rates than predicted, especially when cardiac arrest is avoided. Further randomized trials are warranted.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Mechanical Circulatory Support

Background:

  • Cardiogenic shock carries a high mortality rate, historically around 50%.
  • Intra-aortic balloon pump (IABP) counterpulsation has not demonstrated mortality benefits in previous studies.
  • Early invasive hemodynamic support strategies are being explored to improve outcomes.

Purpose of the Study:

  • To investigate the effectiveness of an early, interdisciplinary, multiprofessional strategy for hemodynamic support in cardiogenic shock.
  • To evaluate the impact of Impella CP microaxial pump use in conjunction with complete revascularization.
  • To assess outcomes in patients with cardiogenic shock prior to intensive care unit admission.

Main Methods:

  • Analysis of 61 cardiogenic shock patients treated with Impella CP for left ventricle support between 2013 and 2016.
  • Inclusion of patients resuscitated before Impella insertion (61%) and comparison with non-resuscitated patients.
  • Stratification of patients based on SHOCK-II trial criteria for comparative analysis.

Main Results:

  • Overall 30-day mortality was 48% (29/61).
  • Mortality was significantly higher in resuscitated patients (65%) compared to non-resuscitated (21%).
  • SHOCK-II-eligible patients showed a 30-day mortality of 24%, lower than the trial's ~40% and predicted scores.

Conclusions:

  • A standardized protocol with early Impella CP support may improve outcomes in cardiogenic shock with isolated left ventricle failure.
  • Pre-implantation cardiac arrest is a critical factor influencing observed mortality.
  • The findings support the need for a randomized controlled trial to confirm these results.
Abstract

Keywords:
Cardiogenic shockSTEMIacute heart failureventricular assist device

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