In-hospital cardiac arrest in Impella-supported cardiogenic shock: insights from the J-PVAD registry
Main finding · 30-day mortalityResult — go to the resultAdjusted hazard ratio 1.54 95% CI 1.41–1.69Authors' conclusion
IHCA before Impella implantation identified a distinct, high-risk CS phenotype with high mortality and a substantial complication burden.
Study context
- Population
- Patients with cardiogenic shock treated with Impella, J-PVAD registryJ-PVAD registry
- Participants
- 8,577 patients
- Exposure
- In-hospital cardiac arrest (IHCA) vs No cardiac arrest
- IHCAn = 1,924
- No cardiac arrestn = 4,595reference
- Out-of-hospital cardiac arrest (OHCA) with return of spontaneous circulation (ROSC)n = 1,321
- OHCA without ROSCn = 737
- Outcome
- Mortality from first Impella initiation
- Follow-up
- 30 days
Methodological detailsmulticentre registry, multivariable Cox models, restricted cubic splines
- Multicentre registry
- Multivariable Cox models
- Restricted cubic splines
Main finding
30-day mortality
Adjusted hazard ratio
1.54
95% CI 1.41–1.69
P < 0.001
By group
IHCA vs No cardiac arrest
aHR 1.54 (95% CI 1.41–1.69); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Factors associated with mortality within IHCA
- Older age, lactate >4.0 mmol/L, creatinine >1.5 mg/dL, longer arrest time and VA-ECMO use associated with higher mortality
- Myocarditis and electrical defibrillation associated with lower mortality
- Nonlinear associations for lactate, creatinine and arrest time (spline analyses)
Safety
Major bleeding, Impella-related bleeding, limb ischemia, ischemic stroke, sepsis
- Higher rates in IHCA vs no cardiac arrest
Original publication
In-hospital cardiac arrest in Impella-supported cardiogenic shock: insights from the J-PVAD registry. Resuscitation. Published 11 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →