著者
Yuki Ikeda Junya Ako Koichi Toda Atsushi Hirayama Koichiro Kinugawa Yoshio Kobayashi Minoru Ono Takashi Nishimura Naoki Sato Takahiro Shindo Morimasa Takayama Satoshi Yasukochi Akira Shiose Yoshiki Sawa J-PVAD Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-22-0476, (Released:2023-01-20)
参考文献数
30
被引用文献数
14

Background: The Impella®percutaneous left ventricular assist device has been available in Japan since 2017. This is the first large-scale registry study to analyze the efficacy and safety of Impella in Japanese patients with acute myocardial infarction with cardiogenic shock (AMICS).Methods and Results: The Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD) has registered all consecutive Japanese patients treated with Impella. We extracted data for 593 AMICS patients from J-PVAD and analyzed 30-day survival and safety profiles. Overall 30-day survival was 63.1%. The 30-day survival of the Impella alone and Impella plus venoarterial extracorporeal membrane oxygenation (ECPELLA) groups was 80.9% and 45.7%, respectively. The Impella alone group was older and had a lower rate of cardiac arrest, milder consciousness disturbance, less inotrope use, lower serum lactate concentrations, higher B-type natriuretic peptide concentrations, and higher left ventricular ejection fraction (LVEF) than the ECPELLA group. Cox regression analysis revealed that older age and comorbid renal disturbance were common risk factors affecting 30-day mortality in both groups. Major adverse events were hemolysis (10.8%), hemorrhage/hematoma (7.6%), peripheral ischemia (4.4%), stroke (1.3%), and thrombosis (0.7%). LVEF improved in both groups during support.Conclusions: AMICS treatment with Impella showed favorable 30-day survival and safety profiles. The survival rate of patients treated with Impella alone was particularly high. Further studies are needed to improve outcomes of patients with ECPELLA support.

言及状況

外部データベース (DOI)

Twitter (6 users, 6 posts, 16 favorites)

The J-PVAD revealed a favorable 30-day survival of Japanese patients with cardiogenic shock due to acute myocardial infarction treated with Impella. By Yuki Ikeda @Kitasato_CV https://t.co/SFaCiYMnAp #circ_j https://t.co/HtQNoeYtpu
【わが国におけるインペラ短期成績悉皆調査/ Circ J】 日本、インペラ使用連続登録593例解析:30日生存率は63.1%。インペラ単独なら80.9%、ECMO併用で45.7%。EFは単独で35→44.7%、ECMO併用でも24.9→44.0%[いずれも有意]。 https://t.co/pbLjtU86qB https://t.co/yEhIBvRldq

収集済み URL リスト