{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T11:26:57Z","timestamp":1793014017777,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japan Abiomed Post-Market Surveillance Programme"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The DanGer shock trial showed a survival benefit of Impella in highly selected patients with ST-elevation myocardial infarction-related cardiogenic shock (STEMI-CS). In real-world settings, however, Impella is often used in broader populations not meeting trial criteria. This study aimed to assess the distribution and outcomes of DanGer shock-eligible and -ineligible acute myocardial infarction-related cardiogenic shock (AMI-CS) patients in a nationwide Japanese registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 3975 AMI-CS patients treated with Impella between 2020 and 2023 were identified from the J-PVAD registry. Patients were stratified into five groups: eligible STEMI-CS, non-eligible STEMI-CS, out-of-hospital cardiac arrest (OHCA), mechanical complications (MCs), and non-STEMI-CS (NSTEMI-CS). Eligible STEMI-CS was defined as STEMI-CS fulfilling all of the following: lactate \u2265 2.5 mmol\/L, systolic blood pressure &amp;lt;100 mmHg or catecholamine use, left ventricular ejection fraction &amp;lt;45%, and shock onset to first Impella support \u226424 h. Thirty-day mortality, associated risk factors, and complications were examined across the five groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eligible STEMI-CS accounted for 35.6% of all AMI-CS cases, with a 30-day mortality of 37.6%. Non-eligible STEMI-CS patients had lower mortality (27.6%), but it increased significantly with advanced age, renal dysfunction, veno-arterial extracorporeal membrane oxygenation use, ventricular arrhythmia, or sepsis. Thirty-day mortality was 51.3% in OHCA (63.4% without return of spontaneous circulation), 39.8% in MC, and 33.3% in NSTEMI-CS groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this nationwide registry, one-third of AMI-CS patients treated with Impella met DanGer shock criteria. Outcomes in non-eligible subgroups were heterogeneous, highlighting the importance of individualized risk assessment in guiding Impella use in real-world practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaf787","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T12:02:24Z","timestamp":1758283344000},"page":"472-486","source":"Crossref","is-referenced-by-count":14,"title":["DanGer shock criteria and outcomes in acute myocardial infarction-related cardiogenic shock treated with Impella: the J-PVAD registry"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0995-5957","authenticated-orcid":false,"given":"Riku","family":"Arai","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , Oyaguchikamicho 30-1, Tokyo 1738610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8430-384X","authenticated-orcid":false,"given":"Keisuke","family":"Kojima","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , Oyaguchikamicho 30-1, Tokyo 1738610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9647-3077","authenticated-orcid":false,"given":"Daisuke","family":"Fukamachi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Nihon University School of Medicine , Oyaguchikamicho 30-1, Tokyo 1738610 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2960-4241","authenticated-orcid":false,"given":"Yasuo","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of 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