ArticleInternational journal of cardiology. Heart & vasculature2022
Use of Impella device in cardiogenic shock and its clinical outcomes: A systematic review and meta-analysis.
Article in International journal of cardiology. Heart & vasculature, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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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
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Mechanical circulatory support for cardiogenic shock: a network meta-analysis of randomized controlled trials and propensity score-matched studies.Intensive care medicine · 2024Pooled it
- Timing of Complete Revascularization in Patients with STEMI and Multivessel Disease: A Systematic Review and Meta-Analysis.Reviews in cardiovascular medicine · 2023Pooled it
- ECMO and Impella Support Strategies as a Bridge to Surgical Repair of Post-Infarction Ventricular Septal Rupture.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Short-Term Percutaneous Mechanical Circulatory Support in Acute Coronary Syndrome with Cardiogenic Shock: Which Device to Choose?Journal of cardiovascular development and disease · 2026Review
- The Role of Impella in Cardiogenic Shock in the Post-DanGer Shock Era.Biomedicines · 2025Review
- Prolonged Impella 5.5 Support in Patients with Cardiogenic Shock: A Single-Center Retrospective Analysis.Journal of clinical medicine · 2025Article
- A Rare Cause of an Acute Myocardial Infarction in a Young Pregnant Woman After Misoprostol-Induced Abortion.Cureus · 2025Article
- Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts.Scientific reports · 2025Article
- Microaxial flow pump in cardiogenic shock: a retrospective cohort study on outcomes and feasibility as a bridge to LVAD implantation.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2025Article
- Immuno-related cardio-vascular adverse events associated with immuno-oncological treatments: an under-estimated threat for cancer patients.Basic research in cardiology · 2025Review
- Acute Ischemic Stroke during Extracorporeal Membrane Oxygenation (ECMO): A Narrative Review of the Literature.Journal of clinical medicine · 2024Review
- Intra-aortic balloon pump is associated with the lowest whereas Impella with the highest inpatient mortality and complications regardless of severity or hospital types.Cardiovascular intervention and therapeutics · 2024Article
- Outcomes of Impella 5.0 and 5.5 for cardiogenic shock: A single-center 137 patient experience.Artificial organs · 2024Article
- Impella 5.5 in left ventricular noncompaction syndrome as bridge to heart transplant.JHLT open · 2024Article
- Cardiogenic shock etiology and exit strategy impact survival in patients with Impella 5.5.The International journal of artificial organs · 2024Article
- Consumptive coagulopathy in the ICU.Hematology. American Society of Hematology. Education Program · 2023Review
- PEAL Score to Predict the Mortality Risk of Cardiogenic Shock in the Emergency Department: An Observational Study.Journal of personalized medicine · 2023Article
- Innovations in ventricular tachycardia ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Review
- Clinical and Procedural Outcomes of IVUS-Guided vs. Angiography-Guided CTO-PCI: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Upgrading extra corporeal life support to ECMELLA using Impella 5.0 in rescued INTERMACS 1 patients, lactate level matters!Journal of thoracic disease · 2023Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Cardiogenic shock (CS) is a life-threatening condition and mechanical circulatory support (MCS) might exert a relevant impact on its clinical course. Among MCS devices, Impella is very promising. Yet, its usefulness is still debated. We performed a meta-analysis of all studies evaluating the clinical impact of Impella in CS. Methods: All studies including patients with CS and treated with Impella were included. The primary endpoint was short-term mortality. Secondary endpoints were vascular access complications and major bleeding. Data synthesis was obtained using random-effects metanalysis. Results: Thirty-three studies and 5204 patients were included. Short-term mortality was 47%. Meta-regression analysis showed that patients age (p = 0.01), higher support level (p = 0.004) and pre-PCI insertion (p < 0.001) were significant moderators for the primary endpoint. Vascular access complications were registered in 6.4% of cases, whereas age (p = 0.05) and diabetes (p = 0.007) were significant predictors. Major bleeding occurred in 16.4% of patients. Meta-analysis of the subgroup of studies comparing Impella to IABP showed no significant difference in short-term mortality (RR = 1.08, p = 0.45), while rates of vascular access complications (p < 0.001) or major bleeding (p < 0.001) were significantly higher with Impella. Subgroup and metaregression analyses showed that these results were influenced by lower adoption rates of higher degree of MCS support (p = 0.003), and by higher vascular complications rates (p = 0.014). Conclusions: Our results suggest that the choice of adequate device size, careful patients selection and optimal timing of MCS initiation are key to clinical success with Impella in CS. Large prospective studies are mandatory to confirm these results deriving from retrospective studies.
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