A Randomized Clinical Trial to Evaluate the Safety and Efficacy of a Percutaneous Left Ventricular Assist Device Versus Intra-Aortic Balloon Pumping for Treatment of Cardiogenic Shock Caused by Myocardial Infarction

Seyfarth, Melchior; Sibbing, Dirk; Bauer, Iris; Fröhlich, Georg; Bott-Flügel, Lorenz; Byrne, Robert A.; Dirschinger, Josef; Kastrati, Adnan; Schömig, Albert

doi:10.1016/j.jacc.2008.05.065

Cited by 914 publications

(628 citation statements)

References 8 publications

(8 reference statements)

Supporting

Mentioning

590

Contrasting

Unclassified

Order By: Relevance

“…The use of IABP is recommended,31, 32 and although newer interventional devices have provided better hemodynamic support than the use of conventional IABP, none of these devices have yet been shown to favorably improve survival compared with the use of IABP 33, 34…”

Section: Discussionmentioning

confidence: 99%

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Nguyen

Yarzebski

Lessard

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundCardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population‐based perspective. Our study objectives were to describe decade‐long trends in the incidence, in‐hospital mortality, and factors associated with the development of CS in 3 temporal contexts: (1) before hospital arrival for acute myocardial infarction (prehospital CS); (2) within 24 hours of hospitalization (early CS); and (3) ≥24 hours after hospitalization (late CS).Methods and ResultsThe study population consisted of 5782 patients with an acute myocardial infarction who were admitted to all 11 hospitals in central Massachusetts on a biennial basis between 2001 and 2011. The overall proportion of patients who developed CS was 5.2%. The proportion of patients with prehospital CS (1.6%) and late CS (1.5%) remained stable over time, whereas the proportion of patients with early CS declined from 2.2% in 2001–2003 to 1.2% in 2009–2011. In‐hospital mortality for prehospital CS increased from 38.9% in 2001–2003 to 53.6% in 2009–2011, whereas in‐hospital mortality for early and late CS decreased over time (35.9% and 64.7% in 2001–2003 to 15.8% and 39.1% in 2009–2011, respectively).ConclusionsDevelopment of prehospital and in‐hospital CS was associated with poor short‐term survival and the in‐hospital death rates among those with prehospital CS increased over time. Interventions focused on preventing or treating prehospital and late CS are needed to improve in‐hospital survival after acute myocardial infarction.

show abstract

Section: Discussionmentioning

confidence: 99%

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Nguyen

Yarzebski

Lessard

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…A recent randomized comparison between the standard IABP (n=13) and the Impella device (n=13) found no device-related technical failures, major bleeding or ischemia. The Impella device was associated with a higher level of hemolysis and one case of lower-limb ischemia following explantation (6). Other documented complications include sensor failure, functional mitral stenosis and displacement/repositioning (10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support

Guirgis

Kumar

Zieroth

et al. 2010

Canadian Journal of Cardiology

View full text Add to dashboard Cite

C urrent hospital administrative practices categorize health care centres in a network of spokes and hubs (1). The 'spokes' are primary care centres that offer immediate yet temporary life-sustaining therapies, and channel the most severe cases to centres or 'hubs' that can provide the long-term treatment not available at the spoke sites. In the setting of mechanical circulatory support, long-term left ventricular assist devices (LVADs) and transplant therapies are only used at a few hub centres. The relatively lower technical requirements of the Impella Recover LP 5.0 LVAD (ABIOMED Inc, USA) translate into greater utilization by spoke centres for the treatment of cardiogenic shock (2,3). Based on a literature review, we report the first case demonstrating successful use of the Impella Recover LP 5.0 LVAD, implanted under local anesthetic, for the purpose of interprovincial spoke-to-hub transport in a bridge-to-bridge-to-transplant procedure. case presentationMr S is a 54-year-old man with a greater than 10-year history of nonischemic dilated cardiomyopathy and symptomatic congestive heart failure managed medically. Following a sudden onset of angina, he presented to his local rural hospital and was diagnosed with an anterior ST elevation myocardial infarction complicated by high-grade atrioventricular block. Following stabilization with dopamine (5 µg/kg/min to 15 µg/kg/min) and insertion of a transvenous pacing wire, the patient was transferred to a tertiary care centre with cardiac surgery onsite, approximately 2 h away. On arrival, the patient had a blood pressure of 86/69 mmHg, a heart rate of approximately 70 beats/min (paced), a respiratory rate of 18 breaths/min and a hemoglobin saturation of 95% on 5 L supplemental oxygen. He had an increased jugular venous pressure of approximately 5 cm to 6 cm, with cool and clammy extremities. The electrocardiogram demonstrated third-degree atrioventricular block with increasing frequency of nonsustained ventricular tachycardia. He underwent emergent percutaneous coronary catheterizaton and thrombectomy of his proximal left anterior descending artery, with the remaining coronary arteries essentially unremarkable. The culprit lesion was not stented due to the patient's severe acetylsalicylic acid allergy and the potential need for heart transplantation. Despite restoration of Thrombolysis in Myocardial Infarction 3 flow following the procedure, the patient required increasing circulatory support, at which time an intra-aortic balloon pump (IABP) was inserted. The documented left ventricular end-diastolic pressure at this time was 39 mmHg. In the hours following, despite the use of inotropic Current hospital administrative practices categorize health care centres in a network of 'spokes' (primary care centres) and 'hubs' (tertiary care centres). For the treatment of cardiogenic shock, long-term left ventricular assist devices (LVADs) and transplant therapies are only used at a few hub centres nationwide and are, thus, only available to patients living in close proximit...

show abstract

“…Data from large well powered randomised controlled trials on novel devices in CS management are lacking. The reports available come from observational studies and retrospective analyses or small trials [39][40][41][42][43]. The Impella (Abiomed, Germany) is a catheter-based, percutaneously implanted axial pump facilitating the blood flow from the left ventricle to the aorta.…”

Section: Novel Devices and Areas Of Future Researchmentioning

confidence: 99%

The management of patients with cardiogenic shock

Sadowski¹,

Janion−Sadowska²

2017

View full text Add to dashboard Cite

Cardiogenic shock is a life-threatening condition with a very poor prognosis. Many disorders may contribute to the development of shock. Of them, acute myocardial infarction is the main culprit. Despite tremendous progress in the field of interventional cardiology, in-hospital and long-term mortality still exceeds 50%. Data from large controlled trials on cardiogenic shock are scarce due to ethical reasons. Nevertheless, there is a chance for acceptable long-term survival in patients treated aggressively. The aim of this review is to summarise the key points of differential diagnosis and to emphasise that in most cases of shock due to acute myocardial infarction primary coronary intervention is the treatment of choice. StreszczenieWstrząs kardiogenny jest stanem zagrożenia życia o bardzo złym rokowaniu. Wiele sytuacji klinicznych przyczynia się do rozwoju wstrząsu, ale ostry zawał serca stanowi najczęstszą przyczynę. Pomimo olbrzymiego postępu w kardiologii interwencyjnej śmiertelność szpitalna i długoterminowa nadal przekracza 50%. Z powodów etycznych nie dysponujemy danymi z kontrolowanych badań klinicznych. Niemniej agresywne leczenie stwarza szansę na uzyskanie akceptowalnego poziomu śmier-telności w tej grupie chorych. Celem pracy jest próba podsumowania najważniejszych elementów diagnostyki różnicowej oraz wykazanie, że pilna rewaskularyzacja za pomocą angioplastyki wieńcowej jest leczeniem z wyboru w większości przypadków.

show abstract

A Randomized Clinical Trial to Evaluate the Safety and Efficacy of a Percutaneous Left Ventricular Assist Device Versus Intra-Aortic Balloon Pumping for Treatment of Cardiogenic Shock Caused by Myocardial Infarction

Cited by 914 publications

References 8 publications

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Ten‐Year (2001–2011) Trends in the Incidence Rates and Short‐Term Outcomes of Early Versus Late Onset Cardiogenic Shock After Hospitalization for Acute Myocardial Infarction

Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support

The management of patients with cardiogenic shock

Contact Info

Product

Resources

About