Impella heart pumps linked to improved high-risk PCI outcomes
High-risk percutaneous coronary intervention (PCI) with an Impella heart pump is associated with better outcomes, including a significantly higher survival rate, than high-risk PCI with an intra-aortic balloon pump (IABP), according to new findings published in the American Journal of Cardiology.[1]
“Impella was approved by the U.S. Food and Drug Administration in 2015 for use during high-risk PCIs; however, its safety and efficacy compared with an IABP has not been evaluated in contemporary practice and remains debated,” wrote lead author Alexandra Lansky, MD, a cardiologist with Yale-New Haven Hospital and professor of medicine at the Yale School of Medicine, and colleagues.
Lansky et al. examined data from nearly 2,200 patients who underwent high-risk PCI from April 2016 to June 2019. While 1,447 patients underwent high-risk PCI with an Impella heart pump, the remaining 709 patients underwent high-risk PCI with an IABP.
Overall, the group found, in-hospital survival was significantly higher among the Impella patients (95.3%) than among the IABP patients (91%). The Impella heart pumps were also linked to a lower myocardial infarction rate (2.5% vs. 11.9%), a lower cardiogenic shock rate (8.3% vs. 18.9%) and a shorter adjusted length of stay (3.4 days vs. 4.8 days).
The authors did note that Impella heart pumps were linked to much higher mean index hospitalization costs ($47,667 vs. $33,684). However, they wrote, the Impella heart pumps were linked to lower readmission lengths-of-stay and readmission costs. After 90 days, this causes the total hospital charges to be comparable for the two treatment options.
“This study from a large contemporary, real-world database is further evidence of the benefits of using Impella during high-risk PCI to stabilize hemodynamics, prevent hemodynamic collapse, enable optimal revascularization and improve clinical outcomes,” Lansky said in a prepared statement.
This analysis was funded by Abiomed, the vendor that manufactors the Impella heart pumps. Also, multiple authors—including Lansky—have working relationships with Abiomed.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.