TABLE 1.
Baseline, procedural, and in‐hospital management characteristics stratified by timing of insertion of Impella 2.5 and CP in relation to the interventional procedure in patients with cardiogenic shock
| Overall (N = 191) | Before (N = 77) | During/after (N = 114) | p‐value | |
|---|---|---|---|---|
| Age | 66 [55;73] | 67 [58;74] | 62 [54;73] | .12 |
| Male | 73% (140) | 73% (56) | 74% (84) | 1 |
| Hypertension | 54% (100) | 56% (42) | 53% (58) | .75 |
| Dyslipidemia | 43% (79) | 48% (36) | 39% (43) | .27 |
| Diabetes mellitus | 35% (65) | 36% (27) | 35% (65) | .88 |
| Chronic pulmonary disease | 11%21 | 13%10 | 10%11 | .64 |
| Prior MI | 36% (67) | 44% (33) | 31% (34) | .08 |
| Prior PCI | 34% (63) | 36% (27) | 33% (36) | .75 |
| Prior CABG | 5%10 | 8%6 | 4%4 | .32 |
| CKDa | 25% (47) | 27%20 | 25% (27) | .86 |
| AF | 10%19 | 11%8 | 10%11 | 1 |
| Prior TIA/stroke | 5%10 | 7%5 | 5%5 | .75 |
| PAD | 14% (26) | 16%12 | 13%14 | .64 |
| Chronic HF | 25% (47) | 31%23 | 22%24 | .22 |
| LVEF, % | 25 [20;30] | 25 [20;30] | 22 [15;32] | .64 |
| RV dysfunction | 24% (42) | 18%13 | 28% (29) | .09 |
| INTERMACS class 1 | 63% (116) | 54% (39) | 69% (77) | .03 |
| Out of hospital cardiac arrest | 25% (46) | 21%16 | 28% (30) | .34 |
| Etiology of cardiogenic shock | ||||
| AMI | 85% (163) | 79% (61) | 90% (102) | .10 |
| Acute myocarditis | 3%5 | 5%4 | 1%1 | |
| Arrhythmias | 4%8 | 4%3 | 4%5 | |
| Other | 8%15 | 12%9 | 5%6 | |
| Laboratory values | ||||
| Ph | 7.4 [7.3;7.5] | 7.4 [7.3;7.5] | 7.4 [7.3;7.4] | .33 |
| HR (bpm) | 100 [80;110] | 100 [77;110] | 98 [80;110] | .86 |
| MAP | 63 [53;78] | 65 [53;80] | 60 [53;77] | .56 |
| Baseline lactate (mmol/l) | 4.7 [2.6;7.5] | 3 [2.2;6.4] | 5 [3.1;7.5] | .04 |
| Baseline hemoglobin (g/dl) | 12.3 [10.6;14.2] | 12.2 [10.7;14.1] | 12.4 [10.4;14.2] | .98 |
| Baseline creatinine (mg/dl) | 1.2 [1;1.8] | 1.3 [0.9;1.8] | 1.3 [1;1.8] | .91 |
| Procedural characteristics | ||||
| PCI performed | 80% (147) | 76% (55) | 82% (92) | .36 |
| Number of diseased vessels | 2 [1;3] | 2.5 [1.3; 3] | 2 [1;3] | .09 |
| Three vessels disease | 42% (75) | 50% (35) | 37% (40) | .09 |
| BCIS myocardial jeopardy score | 8 [6;12] | 10 [6;12] | 8 [6;12] | .42 |
| Left Main stenosis | 36% (60) | 41%25 | 34% (35) | .40 |
| LAD stenosis | 80% (132) | 84% (51) | 78% (81) | .42 |
| CX stenosis | 58% (95) | 69% (42) | 52% (53) | .04 |
| RCA stenosis | 58% (96) | 75% (46) | 48% (50) | <.01 |
| By‐pass occlusion | 1%2 | 2%1 | 1%1 | 1 |
| Number of treated vessels | 1.3 ± 0.9 | 1.6 ± 0.9 | 1.2 ± 0.7 | .01 |
| Three vessels treated | 13%22 | 23%14 | 7%8 | .01 |
| Rotablator | 7%11 | 5%3 | 7%8 | .77 |
| Resuscitation required during index procedure | 21% (40) | 17%13 | 24% (27) | .23 |
| Resuscitation required after index procedure | 31% (58) | 26%20 | 34% (38) | .42 |
| In‐hospital management | ||||
| Impella removed immediately after PCI | 12%21 | 23%16 | 5%5 | <.01 |
| Duration of support (hours) | 53 [24;120] | 48 [8;120] | 72 [24;120] | .06 |
| Use of Impella 2.5 | 61% (117) | 48% (37) | 70% (80) | <.01 |
| Use of Impella CP | 39% (74) | 52% (40) | 30% (34) | <.01 |
| Other cardiopulmonary support used | ||||
| Inotropes | 74% (130) | 69% (50) | 77% (80) | .30 |
| Mechanical ventilation | 75% (139) | 71% (53) | 78% (86) | .30 |
| ECMO | 29% (55) | 22%17 | 33% (38) | .10 |
| IABP | 36% (67) | 23%17 | 45% (50) | <.01 |
Note: Results reported as n (%) for categorical variables and median (interquartile range) or mean ± SD for continuous variables as appropriate.
Abbreviations: AF, atrial fibrillation; AMI, acute myocardial infarction; BCIS, British Cardiovascular Intervention Society; CABG, coronary artery by‐pass graft; CKD, chronic kidney disease; COPD, Chronic pulmonary disease; Cx, circumflex coronary artery; ECMO, ExtraCorporeal Membrane Oxygenation; HF, heart failure; HR, heart rate; IABP, intra‐aortic balloon pump; LAD, left descending artery; LVEF, left ventricular ejection fraction; MAP, mean arterial pressure; MI, myocardial infarction; PAD, peripheral artery disease; PCI, percutaneous coronary intervention; RCA, right coronary artery; RV, right ventricular; TIA, transient ischemic attack.
Defined as eGFR <60 ml/min/1.73 m2.