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Randomized Controlled Trial
. 2021 Dec 6;10(9):1009-1015.
doi: 10.1093/ehjacc/zuab060.

Long-term 5-year outcome of the randomized IMPRESS in severe shock trial: percutaneous mechanical circulatory support vs. intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction

Mina Karami  1 , Erlend Eriksen  2 , Dagmar M Ouweneel  1 , Bimmer E Claessen  1   3 , M Marije Vis  1 , Jan Baan  1 , Marcel Beijk  1 , Erik J S Packer  2 , Krischan D Sjauw  4 , Annemarie Engstrom  1   5 , Alexander Vlaar  6 , Wim K Lagrand  6 , Jose P S Henriques  1
Affiliations
Randomized Controlled Trial

Long-term 5-year outcome of the randomized IMPRESS in severe shock trial: percutaneous mechanical circulatory support vs. intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction

Mina Karami et al. Eur Heart J Acute Cardiovasc Care. .

Abstract

Aims: To assess differences in long-term outcome and functional status of patients with cardiogenic shock (CS) treated by percutaneous mechanical circulatory support (pMCS) and intra-aortic balloon pump (IABP).

Methods and results: Long-term follow-up of the multicentre, randomized IMPRESS in Severe Shock trial (NTR3450) was performed 5-year after initial randomization. Between 2012 and 2015, a total of 48 patients with severe CS from acute myocardial infarction (AMI) with ST-segment elevation undergoing immediate revascularization were randomized to pMCS by Impella CP (n = 24) or IABP (n = 24). For the 5-year assessment, all-cause mortality, functional status, and occurrence of major adverse cardiac and cerebrovascular event (MACCE) were assessed. MACCE consisted of death, myocardial re-infarction, repeat percutaneous coronary intervention, coronary artery bypass grafting, and stroke. Five-year mortality was 50% (n = 12/24) in pMCS patients and 63% (n = 15/24) in IABP patients (relative risk 0.87, 95% confidence interval 0.47-1.59, P = 0.65). MACCE occurred in 12/24 (50%) of the pMCS patients vs. 19/24 (79%) of the IABP patients (P = 0.07). All survivors except for one were in New York Heart Association Class I/II [pMCS n = 10 (91%) and IABP n = 7 (100%), P = 1.00] and none of the patients had residual angina. There were no differences in left ventricular ejection fraction between the groups (pMCS 52 ± 11% vs. IABP 48 ± 10%, P = 0.53).

Conclusions: In this explorative randomized trial of patients with severe CS after AMI, there was no difference in long-term 5-year mortality between pMCS and IABP-treated patients, supporting previously published short-term data and in accordance with other long-term CS trials.

Keywords: Acute myocardial infarction; Cardiogenic shock; Intra-aortic balloon pump; Mechanical circulatory support; Randomized controlled trial.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Time-to-event Kaplan–Meier curves of all-cause mortality in Impella CP and intra-aortic balloon pump-treated patients.
Figure 2
Figure 2
Time-to-event Kaplan–Meier curves for the occurrence of major adverse cardiac and cerebrovascular events in Impella CP and intra-aortic balloon pump-treated patients.
See this image and copyright information in PMC

References

    1. Schramm R, Morshuis M, Schoenbrodt M, Boergermann J, Hakim-Meibodi K, Hata M, Gummert JF.. Current perspectives on mechanical circulatory support. Eur J Cardiothorac Surg 2019;55:i31–i37. - PMC - PubMed
    1. Combes A, Price S, Slutsky AS, Brodie D.. Temporary circulatory support for cardiogenic shock. Lancet 2020;396:199–212. - PubMed
    1. Ouweneel DM, Eriksen E, Seyfarth M, Henriques JPS.. Percutaneous mechanical circulatory support versus intra-aortic balloon pump for treating cardiogenic shock: meta-analysis. J Am Coll Cardiol 2017;69:358–360. - PubMed
    1. Hochman JS, Sleeper LA, Webb JG, Dzavik V, Buller CE, Aylward P, Col J, White HD; SHOCK Investigators. Early revascularization and long-term survival in cardiogenic shock complicating acute myocardial infarction. JAMA 2006;295:2511–2515. - PMC - PubMed
    1. Thiele H, Akin I, Sandri M, de Waha-Thiele S, Meyer-Saraei R, Fuernau G, Eitel I, Nordbeck P, Geisler T, Landmesser U, Skurk C, Fach A, Jobs A, Lapp H, Piek JJ, Noc M, Goslar T, Felix SB, Maier LS, Stepinska J, Oldroyd K, Serpytis P, Montalescot G, Barthelemy O, Huber K, Windecker S, Hunziker L, Savonitto S, Torremante P, Vrints C, Schneider S, Zeymer U, Desch S; CULPRIT-SHOCK Investigators. One-year outcomes after PCI strategies in cardiogenic shock. N Engl J Med 2018;379:1699–1710. - PubMed

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