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Abstract: PO0012

Impact of Impella on Renal Outcomes in High-Risk Percutaneous Coronary Intervention and Cardiogenic Shock: Meta-Analysis

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Yamada, Takayuki, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Satoi, Sera, Mount Sinai Beth Israel Hospital, New York, New York, United States
  • Miyashita, Satoshi, Mount Sinai Beth Israel Hospital, New York, New York, United States
Background

Several studies have examined the impact of Impella on renal outcomes in high-risk PCI and cardiogenic shock (CS). These studies were limited in study sample size and exhibited mixed results. We conducted a meta-analysis of these studies to evaluate the association between the use of Impella and adverse renal outcomes.

Methods

We searched multiple databases up to March 2020 for studies, which evaluated the effect of Impella use on adverse renal outcomes in cardiogenic shock and high-risk PCI. Studies that reported adverse renal outcomes were included. Odds ratios (ORs) with corresponding 95% confidence interval (CI) were synthesized.

Results

A total of ten studies were included in the meta-analysis. The included studies evaluated a total of 1,583 patients with CS or undergoing high-risk percutaneous coronary intervention (PCI), including 695 patients assisted with Impella. The incidence rate of adverse renal outcomes ranged from 0.87% to 47.1% in the Impella group and from 4.48% to 69.6% in the control group. The HRs or ORs ranged from 0.14 to 3.86. Use of Impella was not associated with significant increase in the risk of adverse renal outcomes as compared with controls (OR: 1.15, 95% CI: 0.72-1.83, I2 = 52%). Sub-group analysis revealed that the risk of adverse renal outcomes was comparable with comparators in patients with refractory CS, myocardial infarction complicated by CS, and patients undergoing high-risk PCI.

Conclusion

Our meta-analysis showed that the use of Impella may not have impact on renal outcomes in CS and high-risk PCI. Further randomized controlled trials are needed to better assess the effects of Impella on renal outcomes.