1. Long-term 5-year outcome of the randomized IMPRESS in severe shock trial
- Author
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Marije M. Vis, Bimmer E. Claessen, Jan Baan, Dagmar M. Ouweneel, Mina Karami, Annemarie E. Engström, Erik J S Packer, Krischan D. Sjauw, Erlend Eriksen, José P.S. Henriques, Wim K. Lagrand, Alexander P.J. Vlaar, Marcel A.M. Beijk, Cardiology, ACS - Pulmonary hypertension & thrombosis, ACS - Atherosclerosis & ischemic syndromes, APH - Aging & Later Life, Intensive Care Medicine, ACS - Microcirculation, and Amsterdam Neuroscience - Neuroinfection & -inflammation
- Subjects
medicine.medical_specialty ,Shock, Cardiogenic/etiology ,medicine.medical_treatment ,Left ,Myocardial Infarction ,Shock, Cardiogenic ,Acute myocardial infarction ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Ventricular Function, Left ,Angina ,03 medical and health sciences ,0302 clinical medicine ,Mechanical circulatory support ,Internal medicine ,Cardiogenic/etiology ,medicine ,Humans ,Ventricular Function ,AcademicSubjects/MED00200 ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,Heart Failure and Cardiomyopathies ,AcademicSubjects/MED00460 ,Cardiogenic shock ,Impella ,Intra-aortic balloon pump ,Original Scientific Paper ,Ejection fraction ,Intra-Aortic Balloon Pumping ,business.industry ,Myocardial Infarction/complications ,Percutaneous coronary intervention ,Shock ,Stroke Volume ,General Medicine ,medicine.disease ,AcademicSubjects/MED00170 ,Treatment Outcome ,Randomized controlled trial ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims To assess differences in long-term outcome and functional status of patients with cardiogenic shock (CS) treated by percutaneous mechanical circulatory support (pMCS) and intra-aortic balloon pump (IABP). Methods and results Long-term follow-up of the multicentre, randomized IMPRESS in Severe Shock trial (NTR3450) was performed 5-year after initial randomization. Between 2012 and 2015, a total of 48 patients with severe CS from acute myocardial infarction (AMI) with ST-segment elevation undergoing immediate revascularization were randomized to pMCS by Impella CP (n = 24) or IABP (n = 24). For the 5-year assessment, all-cause mortality, functional status, and occurrence of major adverse cardiac and cerebrovascular event (MACCE) were assessed. MACCE consisted of death, myocardial re-infarction, repeat percutaneous coronary intervention, coronary artery bypass grafting, and stroke. Five-year mortality was 50% (n = 12/24) in pMCS patients and 63% (n = 15/24) in IABP patients (relative risk 0.87, 95% confidence interval 0.47–1.59, P = 0.65). MACCE occurred in 12/24 (50%) of the pMCS patients vs. 19/24 (79%) of the IABP patients (P = 0.07). All survivors except for one were in New York Heart Association Class I/II [pMCS n = 10 (91%) and IABP n = 7 (100%), P = 1.00] and none of the patients had residual angina. There were no differences in left ventricular ejection fraction between the groups (pMCS 52 ± 11% vs. IABP 48 ± 10%, P = 0.53). Conclusions In this explorative randomized trial of patients with severe CS after AMI, there was no difference in long-term 5-year mortality between pMCS and IABP-treated patients, supporting previously published short-term data and in accordance with other long-term CS trials., Graphical Abstract
- Published
- 2021