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Review
. 2025 Jan 18;14(2):611.
doi: 10.3390/jcm14020611.

The Role of Impella in Cardiogenic Shock Complicated by an Acute Myocardial Infarction: A Meta-Analysis

Kiarash Sassani  1   2 , Christian Waechter  1 , Styliani Syntila  1 , Julian Kreutz  1 , Birgit Markus  1 , Nikolaos Patsalis  1 , Davide Di Vece  2 , Bernhard Schieffer  1 , Christian Templin  2 , Georgios Chatzis  1
Affiliations
Review

The Role of Impella in Cardiogenic Shock Complicated by an Acute Myocardial Infarction: A Meta-Analysis

Kiarash Sassani et al. J Clin Med. .

Abstract

Background: Emerging evidence suggests the role of mechanical circulatory support (MCS) devices in the therapy of refractory cardiogenic shock (CS). However, largerandomized trials addressing the role of Impella in the therapy of infarct-associated CS are sparse. As such, evidence coming from comprehensive retrospective studies or meta-analyses is of major importance in order to clarify the role of the Impella device in this setting. Methods: Only clinical trials involving patients receiving Impella 2.5 and Impella CP for treatment of CS caused in terms of acute coronary syndrome (ACS) were included in this meta-analysis. The primary endpoint was 30-day mortality, with major bleeding and ischemic vascular complications serving as secondary endpoints. Results: A total of 18 observational retrospective studies (2617 patients with CS and Impella implantation) were included in this analysis. The mean age of the total participants was 64.7 ± 2.93 years. A mean mortality incidence of 45% was found between all included participants. The ischemia rate was in total 8.5 ± 4.4%, and the incidence of bleeding was 13.9 ± 5.6%. Conclusions: The 30-day mortality rate for patients with ACS-associated CS treated with Impella remains high. The high complication rates underline the importance of Impella use in only a very well-selected population of patients.

Keywords: Impella; acute myocardial infarction; cardiogenic shock; infarct associated cardiogenic shock; meta-analysis; transvalvular microaxial pump.

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Conflict of interest statement

Schieffer, Kreutz, Markus, and Chatzis have received speaker’s honoraria from Abiomed. Patsalis, Di Vece, Templin, Sassani, and Syntila have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow chart of the included studies.
Figure 2
Figure 2
(a) Effect of Impella on 30-day mortality. (b) Funnel plot of Impella on mortality [10,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30].
Figure 3
Figure 3
(a) Forest plot of Impella on ischemia complication. (b) Funnel plot of Impella on ischemia complication [10,14,15,16,17,18,19,20,22,24,25,26,28,29,30].
Figure 4
Figure 4
(a) Effect of Impella on bleeding complication. (b) Funnel plot of Impella on bleeding complication [10,14,15,16,17,18,19,20,22,23,24,25,26,27,28,29,30].
See this image and copyright information in PMC

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