Study Suggests Pre-PCI Insertion of Abiomed’s Impella Heart Pump May Improve Survival in Left Main Coronary Artery Heart Attacks
June 30, 2017—Abiomed, Inc. announced recently published study results suggest that initiation of the company’s Impella 2.5 heart pump before percutaneous coronary intervention (PCI) on an unprotected left main coronary artery (ULMCA) culprit lesion is associated with significant survival benefit in patients supported for cardiogenic shock after an acute myocardial infarction.
The multicenter, retrospective study was published by Perwaiz Meraj, MD, et al in the Journal of Interventional Cardiology. The study included 36 patients from 19 sites in the United States participating in the cVAD Registry to assess whether the initiation of hemodynamic support before PCI would have a survival benefit compared with initiation of support after PCI. The study analyzed patients with acute myocardial infarction complicated by cardiogenic shock undergoing a PCI on a ULMCA. Most these patients (average age, 69 y) were in cardiogenic shock at the time of hospital admission (73%) and had a low mean ejection fraction of 25%.
Study results showed a significant hospital survival to discharge rate when Impella 2.5 was initiated before PCI versus after PCI (55% vs 19%; P = .041). Survival at 30 days was also statistically significant for pre-PCI versus post-PCI (48% vs 13%; P = .004).
In the company’s announcement, Dr. Meraj commented “Patients with cardiogenic shock complicating an acute myocardial infarction due to a ULMCA culprit lesion are some of the sickest and most clinically challenging patients admitted in the cath lab. Our data suggest that early placement of Impella before PCI is vital to survival.” Dr. Meraj is affiliated with Northwell Health, in Manhasset, New York.
According to Abiomed, the Impella 2.5, Impella CP, and Impella 5.0 are FDA-approved heart pumps used to treat heart attack patients in cardiogenic shock. These devices offer the ability for native heart recovery, which can allow patients to return home with their own heart. The Impella 2.5 and Impella CP devices are also approved to treat certain advanced heart failure patients undergoing elective and urgent PCI, such as stenting or balloon angioplasty.