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Updated: Jul 11, 2025
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Multicenter registry of Impella-assisted high-risk percutaneous coronary interventions and cardiogenic shock in
Arkadiusz Pietrasik1, Aleksandra Gąsecka2, Tomasz Pawłowski3
1Department of Cardiology, Medical University of Warsaw, Warszawa, Poland.
Insights
The Impella device shows safety and efficacy in high-risk PCI procedures. However, cardiogenic shock patients treated with Impella experienced higher mortality than seen in other registries, warranting further study.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Impella is a percutaneous mechanical circulatory support device.
- Used for treating cardiogenic shock (CS) and high-risk percutaneous coronary interventions (HR-PCIs).
- IMPELLA-PL is a national retrospective registry in Poland (2014-2021).
Purpose of the Study:
- Evaluate the real-world efficacy and safety of Impella.
- Compare IMPELLA-PL data with other international registries.
- Analyze outcomes for CS and HR-PCI patients.
Main Methods:
- Retrospective analysis of 308 patients from the IMPELLA-PL registry.
- Primary endpoints: in-hospital mortality and 12-month mortality/MACCE.
- Data collected from 20 Polish interventional cardiology centers.
Main Results:
- In-hospital mortality: 76.4% for CS vs. 8.3% for HR-PCI.
- 12-month mortality: 80.0% for CS vs. 18.2% for HR-PCI.
- Complication rates varied, with higher bleeding in CS patients.
Conclusions:
- Impella demonstrates safety and effectiveness in HR-PCIs.
- CS patients had higher risk profiles and mortality compared to other registries.
- Further investigation is needed to understand Impella's benefits in CS.
Background:
Impella is a percutaneous mechanical circulatory support device for treatment of cardiogenic shock (CS) and high-risk percutaneous coronary interventions (HR-PCIs). IMPELLA-PL is a national retrospective registry of Impella-treated CS and HR-PCI patients in 20 Polish interventional cardiological centers, conducted from January 2014 until December 2021.
Aims:
We aimed to determine the efficacy and safety of Impella using real-world data from IMPELLA-PL and compare these with other registries.
Methods:
IMPELLA-PL data were analyzed to determine primary endpoints: in-hospital mortality and rates of mortality and major adverse cardiovascular and cerebrovascular events (MACCE) at 12 months post-discharge.
Results:
Of 308 patients, 18% had CS and 82% underwent HR-PCI. In-hospital mortality rates were 76.4% and 8.3% in the CS and HR-PCI groups, respectively. The 12-month mortality rates were 80.0% and 18.2%, and post-discharge MACCE rates were 9.1% and 22.5%, respectively. Any access site bleeding occurred in 30.9% of CS patients and 14.6% of HR-PCI patients, limb ischemia in 12.7% and 2.4%, and hemolysis in 10.9% and 1.6%, respectively.
Conclusions:
Impella is safe and effective during HR-PCIs, in accordance with previous registry analyses. The risk profile and mortality in CS patients were higher than in other registries, and the potential benefits of Impella in CS require investigation.
