Cardiogenic shock etiology and exit strategy impact survival in patients with Impella 5.5.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-01-01 Epub Date: 2023-12-05 DOI:10.1177/03913988231214180

McKenzie Sicke, Shan Modi, Yeahwa Hong, Michael Bashline, Wyatt Klass, Ed Horn, Barinder S Hansra, Raj Ramanan, Jeffrey Fowler, Nikita Sumzin, Ryan M Rivosecchi, Rahul Chaudhary, Luke A Ziegler, Nicholas R Hess, Nishant Agrawal, David J Kaczorowski, Gavin W Hickey

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Abstract

Background: Despite historical differences in cardiogenic shock (CS) outcomes by etiology, outcomes by CS etiology have yet to be described in patients supported by temporary mechanical circulatory support (MCS) with Impella 5.5.

Objectives: This study aims to identify differences in survival and post-support destination for these patients in acute myocardial infarction (AMI) and acute decompensated heart failure (ADHF) CS at a high-volume, tertiary, transplant center.

Methods: A retrospective review of patients who received Impella 5.5 at our center from November 2020 to June 2022 was conducted.

Results: Sixty-seven patients underwent Impella 5.5 implantation for CS; 23 (34%) for AMI and 44 (66%) for ADHF. AMI patients presented with higher SCAI stage, pre-implant lactate, and rate of prior MCS devices, and fewer days from admission to implantation. Survival was lower for AMI patients at 30 days, 90 days, and discharge. No difference in time to all-cause mortality was found when excluding patients receiving transplant. There was no significant difference in complication rates between groups.

Conclusions: ADHF-CS patients with Impella 5.5 support have a significantly higher rate of survival than patients with AMI-CS. ADHF patients were successfully bridged to heart transplant more often than AMI patients, contributing to increased survival.

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心源性休克的病因和退出策略影响使用 Impella 5.5 的患者的存活率。

背景：尽管不同病因导致的心源性休克（CS）结果存在历史差异，但对于使用 Impella 5.5 临时机械循环支持（MCS）的患者而言，不同病因导致的 CS 结果尚未得到描述：本研究旨在确定在一个高容量、三级移植中心接受急性心肌梗死（AMI）和急性失代偿性心力衰竭（ADHF）支持治疗的这些患者在存活率和支持后去向方面的差异：对 2020 年 11 月至 2022 年 6 月期间在本中心接受 Impella 5.5 的患者进行了回顾性回顾：67名患者因CS接受了Impella 5.5植入手术；23名（34%）患者因AMI接受植入手术，44名（66%）患者因ADHF接受植入手术。急性心肌梗死患者的 SCAI 分期、植入前乳酸水平和之前使用 MCS 装置的比例较高，从入院到植入的天数较少。AMI患者在30天、90天和出院时的存活率较低。在排除接受移植的患者后，全因死亡时间没有差异。两组患者的并发症发生率无明显差异：结论：使用 Impella 5.5 支持的 ADHF-CS 患者的存活率明显高于 AMI-CS 患者。与 AMI 患者相比，ADHF 患者更多地被成功转入心脏移植，从而提高了存活率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.

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