Key result
Impella 5+ support is linked to ~79% survival to discharge in AMI cardiogenic shock.
Why the study?
Evidence regarding the use of the larger Impella 5+ (5.0/5.5) in acute myocardial infarction-related cardiogenic shock remains limited compared to Impella CP.
Observational (n=28)
No
In patients with acute myocardial infarction-related cardiogenic shock, Impella 5+ support was associated with a 79% survival to discharge rate and a low incidence of complications.
May support Impella 5+ consideration in select AMI-CS; hypothesis-generating and requires randomized trials before practice change.
Background Temporary mechanical circulatory support (t-MCS) with Impella CP has recently attracted considerable interest as a therapeutic option for cardiogenic shock (CS) complicating acute myocardial infarction (AMI). In contrast, evidence regarding the use of the larger Impella 5+ (5.0/5.5) in this clinical setting remains limited. This single-centre retrospective study aimed to evaluate the clinical impact of Impella 5+ in patients with AMI-related cardiogenic shock (AMI-CS) Methods and results Between January 2022 and August 2024, 28 patients referred for AMI-CS were treated with Impella 5+. 11 patients were classified as SCAI C, 11 as SCAI D and 6 as SCAI E. On admission, median inotropic score was 10.5 and median left ventricular ejection fraction was 17.5%. 12 patients required concomitant ECMO support (ECPella). 19 patients were escalated from IABPM to Impella 5+. The median length of support was 8 days, 2 patients (7%) received the support for more than 30 days. 1 patient experienced a major bleeding complication. The overall survival during index hospitalization was 79%: 3 patients were bridged to a durable left ventricular assist device (LVAD) and 2 received heart transplantation (HTx). Conclusions Impella 5+ appears to be a safe and effective option in AMI-CS, associated with improved survival and a relatively low incidence of vascular and non-vascular complications. Its advanced features broaden the therapeutic potential of microaxial flow pumps in this high-risk setting.
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Maj et al. (2026) conducted an observational in Acute myocardial infarction-related cardiogenic shock (AMI-CS) (n=28). Impella 5+ (5.0/5.5) was evaluated on Survival to hospital discharge. Impella 5+ support in patients with acute myocardial infarction-related cardiogenic shock resulted in a 79% survival rate to hospital discharge and a low incidence of vascular complications.
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