接受Impella 5.5治疗超过14天的患者的结果:心脏性休克工作组的注册表分析
Manreet K Kanwar1, Nir Uriel2, Anthony Carnicelli3
1Division of Cardiology, University of Chicago, Chicago, Illinois.
概括
超过14天的Impella 5.5支持显示出高有利的结果,特别是作为通往心脏替代疗法的桥梁 (HRT). 长时间使用证明了潜在的益处,在临床实践中需要进一步调查.
科学领域:
- 心脏病学 心脏病学
- 机械循环支持 机械循环支持
- 心脏衰竭管理的管理
背景情况:
- 伊佩拉5.5的支持期为14天,但在实践中使用时间更长.
- 延长使用是常见的,作为通往心脏置换疗法 (HRT) 的桥梁.
研究的目的:
- 为了确定患者的特征和对超过14天的Impella 5.5支持的结果.
- 为了比较短期 (≤14天) 和长期 (>14天) 的结果 (死亡率,严重不良事件) Impella 5.5 支持.
主要方法:
- 对心脏性休克工作组 (CSWG) 注册 (34个国际站点,2022-2024) 的分析.
- 接受Impela 5.5支持超过14天的患者与≤14天的患者的比较.
- 结果分为有利的 (恢复,成功的HRT,活着出院) 或不利的 (死亡,VA-ECMO升级).
主要成果:
- 在927名患者中,有381名患者接受了Impela 5.5支持>14天 (中位数为23.9天).
- 更长的支持组更年轻,更可能患有HF-CS,并且左心室扩大.
- 未调整的存活率更高 (>14天:80% vs ≤14天:68%),HRT率明显更高 (58% vs 38%).
- 大多数 (75%) >14天的患者有良好的结果;与持续时间相比,SAE没有线性增加.
结论:
- 超过14天的Impella 5.5支持与较高的有利结果率有关.
- 扩展Impella 5.5的使用是有效的桥梁HRT.
- 需要进一步的前性研究来调查更长时间的Impella 5.5支持.
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