Table 2.
Main trials that investigated the role of mechanical circulatory support in cardiogenic shock
| Study | Study population | Study information | Primary end-point | Results |
|---|---|---|---|---|
| ISAR-Shock (2008) [79] | 26 patients with AMI-CS | Impella 2.5 vs IABP |
Change in Cardiac Index from baseline to 30 min |
Impella 2.5 improved haemodynamics Secondary end point 30-day mortality: no difference (46% both groups) |
| IABP-SHOCK II (2012) [3] |
600 patients with AMI-CS and revascularisation |
IABP vs MT | 30-day mortality |
No difference in 30-day mortality (39.7% IABP vs 41.3% MT) |
| Protect II Trial (2012) [80] | 448 patients undergoing high-risk percutaneous intervention | IABP vs Impella 2.5 | 30-day mortality |
No MAEs difference at 30 day Impella associated with decreased MAEs at 90 day |
|
IMPRESS in severe Shock (2016) [26] |
48 patients with STEMI-CS | Impella CP vs IABP | 30-day mortality |
No difference in 30-day mortality (50% Impella CP vs 46% IABP) |
| Pappalardo et al. (2017) [28] | 157 patients with CS | VA-ECMO vs ECPella | In-hospital mortality | Lower in-hospital mortality with ECPella (47% vs 80%) |
| Russo et al. (2019) [27] | 3997 patients with CS (meta-analysis) | VA-ECMO vs VA-ECMO + LV unloading (91.7% IABP) | All-cause mortality | Significantly lower mortality VA-ECMO with LV unloading (54% vs 65%) |
| Schrage et al. (2019) [81] | 237 patients with IMPELLA for AMI-CS paired with 237 patients from IABP-SHOCK II trial | IMPELLA vs IABP | 30-day mortality | No significant difference in 30-day all-cause mortality (48.5% versus 46.4%) |
| Patel et al. (2019) [82] | 66 patients with CS | VA-ECMO vs ECPella | 30-day mortality | Significantly lower mortality rate with ECPella (57% vs 78%) |
| Schrage et al. (2020) [29] | 686 patients with CS | VA-ECMO vs ECMELLA | 30-day mortality | Significantly lower 30-day mortality risk with ECMELLA (58.3% vs 65.7%) |
AMI-CS acute myocardial infarction-related cardiogenic shock, CS cardiogenic shock, ECMELLA Impella support plus VA-ECMO, ECPELLA Impella support plus VA-ECMO, IABP intra-aortic balloon pump, LV left ventricular, MAE major adverse events, MT medical therapy, STEMI-CS ST-elevation myocardial infarction-related cardiogenic shock, VA-ECMO veno-arterial extracorporeal membrane oxygenation