Heart, micro pump saves it when it “shuts down” after a heart attack. Mortality reduced by 26%
A artificial micro-pumpthe smallest in the world, reduces mortality by more than a quarter in patients affected by acute myocardial infarction complicated by cardiogenic shock, a condition that occurs when the heart ‘shuts down’, suddenly stopping pushing blood towards vital organs.
In these cases, which affect up to one in 10 heart attack victims, the heart muscle runs out of ‘fuel’blood pressure drops, kidneys and brain stop working and one patient in two dies. Consecrated to the effectiveness of the microaxial flow pump (Impella CP) is the Danish study DanGer Shock, published in the ‘New England Journal of Medicine’ and presented at the 75th Congress of the American College of Cardiology which closed in Atlanta.
“Cardiogenic shock, after an acute myocardial infarction, is one condition of inadequate perfusion of the heart due to necrosis of the muscle cells involved in the contraction of the organ – he explains Pasquale Perrone Filardi, president of the Italian Society of Cardiology (Sic) and director of the School of Specialization in Cardiology of the Federico II University of Naples – It affects 5% to 10% of patientspatients with acute myocardial infarction and more than half of these patients die during hospitalization.”
Until now – experts recall – previous research had not highlighted a benefit, in terms of survival, for the use of a mechanical support device based on a particular pump which ‘fishes’ the oxygenated blood from the ventricle and introduces it into the aorta.
A device on whose safety the US FDA had launched a ‘warning’. The new study involved 355 patients randomly divided into two groups: 179 used the microaxial flow pump and 176 used standard therapy.
The death for any reason it occurred in 82 out of 179 patients (45.8%) in the microaxial flow pump group and in 103 of 176 patients (58.5%) in the standard therapy group.
“After 25 years – he comments Ciro Indolfipast president of Sic and full professor of Cardiology at the Magna Graecia University of Catanzaro – this is the first study that demonstrates that it is possible to reduce mortality by 26% in patients with cardiogenic shock, an extremely serious condition that leads to death in 50% of cases.
Patient selection was the key element of the results of this study which documented a real survival benefit in a pathology where medical therapy is usually ineffective. However – specifies the specialist – the use of this catheter, which is large, can cause problems arterial complicationswhich in the future can be reduced thanks to more careful control of vascular access”.
The study also demonstrated that the survival curves separate earlywith mortality in controls increasing in the 180 days thereafter at the beginning of the observation, while mortality remains stable after 30 days in patients treated with the micro-pump.
“These additional therapeutic strategies, associated with timely treatment of the heart attack with the coronary stent – they conclude Indolfi and Perrone Filardi – will contribute to a increased survival in subjects affected by this pathology which, unfortunately, still represents the number one cause of death in men and women”.