The use of an intra-aortic balloon pump reduced in-hospital mortality to 14.5% compared to 35.5% in the medical therapy only group in patients with takotsubo syndrome and cardiogenic shock.
Observational
Yes
Does mechanical circulatory support (IABP or Impella) reduce in-hospital mortality in patients with takotsubo syndrome complicated by cardiogenic shock compared to medical therapy alone?
309 patients with takotsubo syndrome (TTS) complicated by cardiogenic shock from the International Takotsubo Registry (multinational, 56 sites in 16 countries). Mean age 64.6 years, 69.8% female.
Mechanical circulatory support (MCS), specifically intra-aortic balloon pump (IABP) or Impella device.
Medical therapy only.
In-hospital mortality.hard clinical
In patients with takotsubo syndrome and cardiogenic shock, IABP use was associated with lower in-hospital mortality compared to medical therapy alone, whereas Impella use was not associated with improved survival and had higher complication rates.
Abstract Background Cardiogenic shock complicates takotsubo syndrome (TTS) in approximately 10% of cases. The effectiveness of mechanical circulatory support (MCS) for managing cardiogenic shock in TTS remains unknown. Methods We assessed outcomes in TTS patients with cardiogenic shock who received MCS compared to medical therapy only by using data from the International Takotsubo Registry. Two independent propensity scores were computed to investigate outcomes of patients with an intra-aortic balloon pump (IABP) vs. medical therapy only (1:2 propensity score matched cohort) and patients with an Impella vs. medical therapy only (1:1 propensity score matched cohort). The primary endpoint was in-hospital mortality and the secondary outcomes included MCS-related complications. Results Among 3740 eligible patients, 309 (8.3%) patients had cardiogenic shock, of whom 112 (36.2%) had MCS and 197 (63.8%) had medical therapy only. After propensity-score matching, the use of an IABP was found to be associated with a lower in-hospital mortality rate than medical therapy only (14.5% vs. 35.5%, P = 0.002), while mortality rates in the Impella group and medical therapy only group were comparable (25.0% vs. 29.2%, P = 0.75). MCS-related complications occurred in 6.0% of the IABP cohort and in 31.3% of Impella cohort. Conclusion Active MCS has been increasingly used for the management of cardiogenic shock in patients with TTS. This observational study could not demonstrate an association with improved mortality with an Impella device, but possibly with an IABP when compared to patients with medical management only. MCS-related complications occurred more frequently in the Impella cohort than in the IABP cohort. Further data are required to confirm results of the present study. Graphical Abstract
Building similarity graph...
Analyzing shared references across papers
Loading...
Victoria L. Cammann
Victor Schweiger
Konrad A. Szawan
Clinical Research in Cardiology
University of Oxford
University of California, San Francisco
University of Southern California
Building similarity graph...
Analyzing shared references across papers
Loading...
Cammann et al. (Mon,) conducted a observational in Takotsubo syndrome complicated by cardiogenic shock (n=309). Intra-aortic balloon pump (IABP) / Impella vs. Medical therapy only was evaluated on In-hospital mortality rate (OR 0.35, 95% CI 0.21-0.59, p=0.002). The use of an intra-aortic balloon pump reduced in-hospital mortality to 14.5% compared to 35.5% in the medical therapy only group in patients with takotsubo syndrome and cardiogenic shock.
www.synapsesocial.com/papers/69843383f1d9ada3c1fb0a79 — DOI: https://doi.org/10.1007/s00392-025-02832-z