The implantation of a microaxial flow pump (Impella CP; Abiomed) in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock increases the survival rate at 6 months compared with standard care alone. This finding from the Danish–German Cardiogenic Shock (DanGer Shock) trial was presented at ACC.24 and published in The New England Journal of Medicine.

In the multicentre DanGer Shock trial, conducted across 14 centres in Denmark, Germany and the UK, 360 patients with STEMI complicated by cardiogenic shock were randomly assigned to receive either a microaxial flow pump plus standard care or standard care only. The primary end point (death from any cause within 180 days) was significantly lower in the Impella CP group than in the standard care group (45.8% versus 58.5%; HR 0.74, 95% CI 0.55–0.99, P = 0.04). Further analysis found a significant decrease in the need for additional mechanical heart support, heart transplantation or death in the Impella CP group compared with standard care (HR 0.72, 95% CI 0.55–0.95). However, patients in the Impella CP group had a higher risk of complications, including moderate or severe bleeding, leg ischaemia, the need for kidney replacement therapy and sepsis.