{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:27:09Z","timestamp":1789547229229,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,2,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Venoarterial extracorporeal membrane oxygenation (VA\u2010ECMO) is increasingly used for patients with cardiogenic shock. Although Impella or intra\u2010aortic balloon pump (IABP) is frequently used for left ventricular unloading (LVU) during VA\u2010ECMO treatment, there are limited data on comparative outcomes. We compared outcomes of Impella and IABP for LVU during VA\u2010ECMO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using the Nationwide Readmissions Database between 2016 and 2020, we analyzed outcomes in 3 groups of patients with cardiogenic shock requiring VA\u2010ECMO based on LVU strategies: extracorporeal membrane oxygenation (ECMO) only, ECMO with IABP, and ECMO with Impella. Of 15\u2009980 patients on VA\u2010ECMO, IABP and Impella were used in 19.4% and 16.4%, respectively. The proportion of patients receiving Impella significantly increased from 2016 to 2020 (6.5% versus 25.8%;\n              <jats:italic>P<\/jats:italic>\n              \u2010trend&lt;0.001). In\u2010hospital mortality was higher with ECMO with Impella (54.8%) compared with ECMO only (50.4%) and ECMO with IABP (48.4%). After adjustment, ECMO with IABP versus ECMO only was associated with lower in\u2010hospital mortality (adjusted odds ratio [aOR], 0.83;\n              <jats:italic>P<\/jats:italic>\n              =0.02). ECMO with Impella versus ECMO only had similar in\u2010hospital mortality (aOR, 1.09;\n              <jats:italic>P<\/jats:italic>\n              =0.695) but was associated with more bleeding (aOR, 1.21;\n              <jats:italic>P<\/jats:italic>\n              =0.007) and more acute kidney injury requiring hemodialysis (aOR, 1.42;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). ECMO with Impella versus ECMO with IABP was associated with greater risk of acute kidney injury requiring hemodialysis (aOR, 1.49;\n              <jats:italic>P<\/jats:italic>\n              =0.002), higher in\u2010hospital mortality (aOR, 1.32;\n              <jats:italic>P<\/jats:italic>\n              =0.001), and higher 40\u2010day mortality (hazard ratio, 1.25;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In patients with cardiogenic shock on VA\u2010ECMO, LVU with Impella, particularly with 2.5\/CP, was not associated with improved survival at 40\u2009days but was associated with increased adverse events compared with IABP. More data are needed to assess Impella platform\u2010specific comparative outcomes of LVU.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032607","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T11:41:26Z","timestamp":1705664486000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Impella Versus Intra\u2010Aortic Balloon Pump in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: An Observational Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8825-0757","authenticated-orcid":false,"given":"Ilhwan","family":"Yeo","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine New York\u2010Presbyterian Hospital New York NY"},{"name":"Weill Cornell Cardiovascular Outcomes Research Group (CORG) Weill Cornell Medicine New York 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Cardiology, Department of Medicine, Weill Cornell Medicine New York\u2010Presbyterian Hospital New York NY"},{"name":"Weill Cornell Cardiovascular Outcomes Research Group (CORG) Weill Cornell Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-9360","authenticated-orcid":false,"given":"Jim W.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine New York\u2010Presbyterian Hospital New York NY"},{"name":"Weill Cornell Cardiovascular Outcomes Research Group (CORG) Weill Cornell Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4424-4528","authenticated-orcid":false,"given":"Robert M.","family":"Minutello","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine New York\u2010Presbyterian Hospital New York 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