Patient Characteristics and Early Clinical Outcomes With Impella 5.5: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiovascular Medicine
• Medical Devices
• Clinical Outcomes Research

Background:

• Limited data exists on outcomes associated with the Impella 5.5 heart support device.
• This study aims to consolidate patient and treatment characteristics and early clinical outcomes for Impella 5.5 use.

Approach:

• A systematic literature search was performed across PubMed, Scopus, and Cochrane databases (September 2019 - March 2023).
• Included studies reported outcomes for at least 5 patients, focusing on adverse events, survival to hospital discharge, and 30-day survival.
• Random-effect models were employed for survival outcomes, with bias assessed using funnel plots and Egger's tests.

Key Points:

• Fifteen studies involving 707 patients were reviewed, with a mean support duration of 9.9 days.
• For patients predominantly supported by Impella 5.5 (>60%), pooled survival to discharge was 68% and 30-day survival was 65%, with significant heterogeneity.
• In a subgroup of 294 patients exclusively on Impella 5.5, survival to discharge was 78% with no significant heterogeneity.

Conclusions:

• The Impella 5.5 heart pump demonstrates encouraging early clinical outcomes, particularly in patients receiving exclusive support.
• These findings provide crucial benchmarks for evaluating Impella 5.5 performance as clinical adoption grows.
• Further research is warranted to refine understanding of Impella 5.5 efficacy across diverse patient populations and clinical scenarios.