Implanting the Impella CP heart pump within hours of a heart attack may improve 6-month survival in patients with cardiogenic shock, according to recent findings.
Cardiogenic shock—which occurs in about 5% to 10% of heart attack cases when the heart is unable to sufficiently pump blood—is a leading factor in heart attack–related mortality. The Impella CP heart pump is a percutaneous microaxial flow pump implanted into the left chamber of the heart that is designed to expel oxygenated blood from the left ventricle into the body at 3.5 L/minute.
In the DanGer Shock trial—results of which were presented by Møller et al at the American College of Cardiology (ACC) Annual Scientific Session 2024 and simultaneously published in The New England Journal of Medicine—researchers randomly assigned 360 patients who experienced ST-elevation myocardial infarction with cardiogenic shock who were treated at 14 medical centers across Denmark, Germany, and the United Kingdom to undergo either implantation of the Impella CP heart pump plus standard care or standard care alone. After a follow-up of 6 months, the researchers found that among the 355 patients included in the final analysis, the patients in the Impella CP heart pump plus standard care group experienced a mortality rate of 45.8% vs 58.5% among those in the standard care alone group. The patients in the combination treatment group also experienced a reduction in additional mechanical heart support, heart transplant, and mortality, but no statistically significant difference in days out of the hospital compared with those in the standard care alone group.
Although the benefits appeared to continue past 30 days of treatment initiation, those who received the Impella CP heart pumps experienced a higher rate of complications such as bleeding, limb ischemia, renal replacement therapy, and sepsis. Further studies may be needed to assess the benefits of the heart pump in a more diverse group of patients.
“This is the first time in a very long time that we have a positive study for managing cardiogenic shock. [We] think this will be a routine device that will be used in these … patients,” concluded lead study author Jacob E. Møller, MD, Professor in the Department of Cardiology at the Odense University Hospital and a consultant at the Cardiac Intensive Care Unit at Rigshospitalet in Copenhagen.