{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T15:18:06Z","timestamp":1778599086247,"version":"3.51.4"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1775,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The mortality in cardiogenic shock (CS) is high. The role of specific mechanical circulatory support (MCS) systems is unclear. We aimed to compare patients receiving Impella versus ECLS (extracorporal life support) with regard to baseline characteristics, feasibility, and outcomes in CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This is a retrospective cohort study including CS patients over 18 years with a complete follow-up of the primary endpoint and available baseline lactate level, receiving haemodynamic support either by Impella 2.5 or ECLS from two European registries. The decision for device implementation was made at the discretion of the treating physician. The primary endpoint of this study was all-cause mortality at 30 days. A propensity score for the use of Impella was calculated, and multivariable logistic regression was used to obtain adjusted odds ratios (aOR).<\/jats:p>\n                    <jats:p>In total, 149 patients were included, receiving either Impella (n = 73) or ECLS (n = 76) for CS. The feasibility of device implantation was high (87%) and similar (aOR: 3.14; 95% CI: 0.18\u201356.50; P = 0.41) with both systems. The rates of vascular injuries (aOR: 0.95; 95% CI: 0.10\u20133.50; P = 0.56) and bleedings requiring transfusions (aOR: 0.44; 95% CI: 0.09\u20132.10; P = 0.29) were similar in ECLS patients and Impella patients. The use of Impella or ECLS was not associated with increased odds of mortality (aOR: 4.19; 95% CI: 0.53\u201333.25; P = 0.17), after correction for propensity score and baseline lactate level. Baseline lactate level was independently associated with increased odds of 30 day mortality (per mmol\/L increase; OR: 1.29; 95% CI: 1.14\u20131.45; P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In CS patients, the adjusted mortality rates of both ECLS and Impella were high and similar. The baseline lactate level was a potent predictor of mortality and could play a role in patient selection for therapy in future studies. In patients with profound CS, the type of device is likely to be less important compared with other parameters including non-cardiac and neurological factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13200","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T17:17:04Z","timestamp":1612977424000},"page":"953-961","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Impella versus Extracorporal Life Support in Cardiogenic Shock: A Propensity Score Adjusted Analysis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4024-0220","authenticated-orcid":false,"given":"Bernhard","family":"Wernly","sequence":"first","affiliation":[{"name":"Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University , Salzburg ,","place":["Austria"]},{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Karami","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Amsterdam University Medical Center , Amsterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemarie E.","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Erasmus University Rotterdam , Rotterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Windecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Hunziker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas F.","family":"L\u00fcscher","sequence":"additional","affiliation":[{"name":"Imperial College, Research, Education & Development, Royal Brompton and Harefield Hospitals London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose P.","family":"Henriques","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Amsterdam University Medical Center , Amsterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus W.","family":"Ferrari","sequence":"additional","affiliation":[{"name":"HSK, Clinic of Internal Medicine I, Helios-Kliniken , Wiesbaden ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Binneb\u00f6\u00dfel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital D\u00fcsseldorf , D\u00fcsseldorf ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryna","family":"Masyuk","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital D\u00fcsseldorf , D\u00fcsseldorf ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Niederseer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Abel","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology and Critical Care Medicine, Department of Internal Medicine B, University Medicine Greifswald , Greifswald ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Fuernau","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Intensive Care Medicine, Medical Clinic II, University Heart Center L\u00fcbeck , L\u00fcbeck ,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck , Luebeck ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Franz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinic of Internal Medicine I, Jena University Hospital, Friedrich Schiller University Jena , Jena ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte","family":"Kelm","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital D\u00fcsseldorf , D\u00fcsseldorf ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias C.","family":"Busch","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology and Critical Care Medicine, Department of Internal Medicine B, University Medicine Greifswald , Greifswald ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Greifswald , Greifswald ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan B.","family":"Felix","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology and Critical Care Medicine, Department of Internal Medicine B, University Medicine Greifswald , Greifswald ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Greifswald , Greifswald 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