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- Title
Propensity score‐based analysis of 30‐day survival in cardiogenic shock patients supported with different microaxial left ventricular assist devices.
- Authors
Nersesian, Gaik; Potapov, Evgenij V.; Nelki, Vivian; Stein, Julia; Starck, Christoph; Falk, Volkmar; Schoenrath, Felix; Krackhardt, Florian; Tschöpe, Carsten; Spillmann, Frank
- Abstract
Background and methods: Microaxial left ventricular assist devices are used increasingly for treating cardiogenic shock. We compared the short‐term outcome of patients supported with different microaxial devices for cardiogenic shock. A retrospective propensity score‐adjusted analysis was performed in cardiogenic shock patients treated with either the Impella CP (n = 64) or the Impella 5.0/5.5 (n = 62) at two tertiary cardiac care centers between 1/14 and 12/19. Results: Patients in the Impella CP group were significantly older (69.6 ± 10.7 vs. 58.7 ± 11.9 years, p =.001), more likely in INTERMACS profile 1 (76.6% vs. 50%, p =.003) and post‐C‐reactive protein (CPR) (36% vs. 13%, p =.006). The median support time was 2.0 days [0.0, 5.3] in the CP group vs. 8.5 days [4.3, 15.8] in the 5.0/5.5 group (p <.001). The unadjusted 30‐day survival was significantly higher in the Impella 5.0/5.5 group (58% vs. 36%, p =.021, odds ratio [OR] for 30‐day survival on Impella 5.0/5.5 was 3.68 [95% confidence interval [CI]: [1.46–9.90]], p =.0072). After adjustment, the 30‐day survival was similar for both devices (OR: 1.23, 95% CI: [0.34–4.18], p =.744). Lactate levels above 8 mmol/L and preoperative CPR were associated with a significant mortality increase in both cohorts (OR: 10.7, 95% CI: [3.45–47.34], p <.001; OR: 13.2, 95% CI: [4.28–57.89], p <.001, respectively). Conclusion: Both Impella devices offer a similar effect with regard to survival in cardiogenic shock patients. Preoperative CPR or lactate levels exceeding 8 mmol/L immediately before implantation have a poor prognosis on Impella CP and Impella 5.0/5.5.
- Publication
Journal of Cardiac Surgery, 2021, Vol 36, Issue 11, p4141
- ISSN
0886-0440
- Publication type
Article
- DOI
10.1111/jocs.15932