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Propensity score-based analysis of 30-day survival in cardiogenic shock patients supported with different microaxial left ventricular assist devices
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  • Gaik Nersesian,
  • Evgenij Potapov,
  • Vivian Nelki,
  • Julia Stein,
  • Christoph Starck,
  • Volkmar Falk,
  • Felix Schoenrath,
  • Florian Krackhardt,
  • Carsten Tschoepe,
  • Frank Spillmann
Gaik Nersesian
Deutsches Herzzentrum Berlin
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Evgenij Potapov
Deutsches Herzzentrum Berlin
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Vivian Nelki
Charité Universitätsmedizin Berlin
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Julia Stein
DHZB Dienstleisungs GmbH
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Christoph Starck
Deutsches Herzzentrum Berlin
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Volkmar Falk
Deutsches Herzzentrum Berlin
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Felix Schoenrath
Deutsches Herzzentrum Berlin
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Florian Krackhardt
Charité Universitätsmedizin Berlin
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Carsten Tschoepe
Charité Universitätsmedizin Berlin
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Frank Spillmann
Charité Universitätsmedizin Berlin
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Abstract

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.

Peer review status:ACCEPTED

24 Apr 2021Submitted to Journal of Cardiac Surgery
24 Apr 2021Submission Checks Completed
24 Apr 2021Assigned to Editor
26 Apr 2021Reviewer(s) Assigned
08 Jun 2021Review(s) Completed, Editorial Evaluation Pending
10 Jun 2021Editorial Decision: Revise Major
22 Jun 20211st Revision Received
24 Jun 2021Submission Checks Completed
24 Jun 2021Assigned to Editor
24 Jun 2021Reviewer(s) Assigned
14 Jul 2021Review(s) Completed, Editorial Evaluation Pending
14 Jul 2021Editorial Decision: Accept