ArticleESC heart failure2021
Impella versus extracorporal life support in cardiogenic shock: a propensity score adjusted analysis.
Article in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Impella Versus VA-ECMO in Cardiogenic Shock: An Updated Systematic Review and Meta-Analysis With Exploratory Matched-Cohort Analyses.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Pooled it
- IMPELLA COMPARED TO VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION IN CARDIOGENIC SHOCK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF PROPENSITY SCORE-MATCHED STUDIES.Shock (Augusta, Ga.) · 2025Pooled it
- Mortality in cardiogenic shock patients receiving mechanical circulatory support: a network meta-analysis.BMC cardiovascular disorders · 2022Pooled it
- Impella in killip class IV acute myocardial infarction complicated by pulseless ventricular arrhythmia.Cardiovascular intervention and therapeutics · 2026Article
- Review
- Cardiogenic Shock: Focus on Non-Cardiac Biomarkers.Current heart failure reports · 2024Review
- AI driven mechanical circulatory support: Can AI and Impella team up to beat cardiogenic shock.ESC heart failure · 2024Article
- Mechanical Circulatory Support with Impella: Principles, Evidence, and Daily Practice.Journal of clinical medicine · 2024Review
- Temporary Mechanical Circulatory Support: Left, Right, and Biventricular Devices.Current cardiology reviews · 2023Review
- PRospective REgistry of PAtients in REfractory cardiogenic shock-The PREPARE CardShock registry.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2022Article
- Comparison of Mechanical Support with Impella or Extracorporeal Life Support in Post-Cardiac Arrest Cardiogenic Shock: A Propensity Scoring Matching Analysis.Journal of clinical medicine · 2021Article
- Impella versus extracorporal life support in cardiogenic shock: a propensity score adjusted analysis.ESC heart failure · 2021Article
Corrections and comments
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Authors and funding
20 authors at 12 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe mortality in cardiogenic shock (CS) is high. The role of specific mechanical circulatory support (MCS) systems is unclear. We aimed to compare patients receiving Impella versus ECLS (extracorporal life support) with regard to baseline characteristics, feasibility, and outcomes in CS. METHODS AND
resultsThis is a retrospective cohort study including CS patients over 18 years with a complete follow-up of the primary endpoint and available baseline lactate level, receiving haemodynamic support either by Impella 2.5 or ECLS from two European registries. The decision for device implementation was made at the discretion of the treating physician. The primary endpoint of this study was all-cause mortality at 30 days. A propensity score for the use of Impella was calculated, and multivariable logistic regression was used to obtain adjusted odds ratios (aOR). In total, 149 patients were included, receiving either Impella (n = 73) or ECLS (n = 76) for CS. The feasibility of device implantation was high (87%) and similar (aOR: 3.14; 95% CI: 0.18-56.50; P = 0.41) with both systems. The rates of vascular injuries (aOR: 0.95; 95% CI: 0.10-3.50; P = 0.56) and bleedings requiring transfusions (aOR: 0.44; 95% CI: 0.09-2.10; P = 0.29) were similar in ECLS patients and Impella patients. The use of Impella or ECLS was not associated with increased odds of mortality (aOR: 4.19; 95% CI: 0.53-33.25; P = 0.17), after correction for propensity score and baseline lactate level. Baseline lactate level was independently associated with increased odds of 30 day mortality (per mmol/L increase; OR: 1.29; 95% CI: 1.14-1.45; P < 0.001).
conclusionsIn CS patients, the adjusted mortality rates of both ECLS and Impella were high and similar. The baseline lactate level was a potent predictor of mortality and could play a role in patient selection for therapy in future studies. In patients with profound CS, the type of device is likely to be less important compared with other parameters including non-cardiac and neurological factors.
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