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IMP-IT Subgroup Analysis on Timing of Impella® and Outcomes in Cardiogenicshock or High-Risk Percutaneous Coronary Revascularization Now Published In: Catheter Cardiovasc Interv. 2021;1–13.

This is the largest European series of patients with Impella support demonstrating real-life data about Impella usage during the last years.

Tarantini G, Masiero G, Burzotta F, et al. Timing of Impella implantation and outcomes in cardiogenic shock or high-risk percutaneous coronary revascularization. Catheter Cardiovasc Interv. 2021;1–13. 

https://doi.org/10.1002/ccd.29674 TARANTINI ET AL. 13

The use of Impella devices for both CGS and protected PCI indications has grown exponentially over the last few years. In the Italian IMP-IT registry more than half of the patients had an Impella implanted for CGS and in most of the cases the cause was AMICS. Less than half of the patients had protected PCI with Impella support.

Objective:

To evaluate the role of the microaxial percutaneous mechanical circulatory support device (Impella® pump) implantation pre‐percutaneous coronary intervention (PCI) versus during/after PCI in cardiogenic shock (CS) and high‐risk PCI populations.

Results:

  • Pre-procedural insertion was associated with an improvement in 1-year survival in patients with AMI-CS treated with PCI (p <0.05) and HR-PCI (p <0.01).
  • Among patients undergoing HR-PCI, early Impella support was also associated with a lower rate of the composite of mortality, re-hospitalization for heart failure, and need for left-ventricular assist device/heart transplantation at 1-year (p <0.05).
  • Furthermore, Impella use during/after PCI was associated with an increased in-hospital life-threatening and severe bleeding among patients with AMI-CS receiving PCI (7 vs. 16%, p = 0.1) and HR-PCI (1 vs. 9%, p = 0.02).

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