{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:50:02Z","timestamp":1791395402182,"version":"4.3.3"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute myocardial infarction with cardiogenic shock (AMI\u2010CS) remains highly fatal despite advances in revascularization and intensive care. The Impella, a micro\u2010axial pump, offers a potential balance of hemodynamic support and minimal invasiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study examined its optimal configuration of low\u2010 versus high\u2010capacity for effectiveness and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and pooled analysis of 20 studies, including three randomized controlled trials (RCTs) and 3896 AMI\u2010CS patients, comparing high\u2010capacity (Impella 5.0\/5.5) versus low\u2010capacity (Impella 2.5\/CP) devices. The primary outcome was in\u2010hospital or 30\u2010day mortality, with secondary endpoints including mortality on support, ischemic and bleeding complications, acute kidney injury requiring renal replacement therapy (RRT), and hemolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the included patients, 2022 received low\u2010capacity Impella, while 771 received high\u2010capacity Impella. The high\u2010capacity Impella group demonstrated lower in\u2010hospital or 30\u2010day mortality (41.4% vs. 45.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045) and significantly reduced mortality on support (17.9% vs. 46.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Major bleeding events (1.4% vs. 6.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and ischemic complications (3.9% vs. 5.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05) were also lower in the high\u2010capacity group. However, transfusion requirements were higher in the high\u2010capacity Impella cohort (52.1% vs. 23.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There were no significant differences in stroke rates (4.3% vs. 4.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.0) or AKI requiring RRT (36.5% vs. 34.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.69).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High\u2010capacity Impella, when compared to low\u2010capacity devices, may provide superior survival benefits and lower complication rates, particularly in reducing ischemic and major bleeding events, in AMI\u2010CS patients. These findings support the early consideration of high\u2010capacity Impella in treatment algorithms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70442","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T03:35:26Z","timestamp":1767929726000},"page":"1246-1253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Low\u2010 Versus High\u2010capacity Impella for CS After AMI: A Systematic Review and Pooled Data Analysis"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2897-8919","authenticated-orcid":false,"given":"Dan","family":"Haberman","sequence":"first","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beni","family":"Verma","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waiel","family":"Abusnina","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-7049","authenticated-orcid":false,"given":"Jason","family":"Galo","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalyan R.","family":"Chitturi","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington 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Interventional Cardiology MedStar Washington Hospital Center Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Salman","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine MedStar Washington Hospital Center Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4623-600X","authenticated-orcid":false,"given":"Vaishnavi","family":"Sawant","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6026-9097","authenticated-orcid":false,"given":"Itsik","family":"Ben\u2010Dor","sequence":"additional","affiliation":[{"name":"Section of Interventional Cardiology MedStar Washington Hospital Center Washington 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