Propensity score-based analysis of 30-day survival in cardiogenic shock
patients supported with different microaxial left ventricular assist
Microaxial LVADs are increasingly used for cardiogenic shock treatment.
We compared the short-term outcome of patients supported with different
microaxial devices for cardiogenic shock. A retrospective propensity
score-adjusted analysis was performed in cardiogenic shock patients
treated with either the Impella CP (n=64) or the Impella 5.0/5.5 (n=62)
at two tertiary cardiac care centers between 1/14 and 12/19. Patients in
the Impella CP group were significantly older (69.6±10.7 vs 58.7±11.9
years, p=0.001), more likely in an INTERMACS level 1 (76.6% vs 50%,
p=0.003) and post CPR (36% vs 13%, p=0.006). The unadjusted 30-day
survival was significantly higher in Impella 5.0/5.5 group (58% vs
36%, p=0.021, odds ratio (OR) for 30-day survival on Impella 5.0/5.5
was 3.68 (95% CI [1.46-9.90], p=0.0072). After adjustment, the
30-day survival was similar for both devices (OR 1.23, 95% CI
[0.34-4.18], p=0.744). Lactate levels above 8 mmol/L and
preoperative CPR were associated with a significant mortality increase
in both cohorts (OR=10.7, 95% CI [3.45-47.34], p<0.001;
OR=13.2, 95% CI [4.28-57.89], p<0.001, respectively).
Both Impella devices offer a similar effect with regards to survival in
cardiogenic shock patients. Preoperative CPR or lactate levels exceeding
8 mmol/L immediately before implantation have a poor prognosis on
Impella CP and Impella 5.0/5.5.