Review RECOVER III and RECOVER IV Studies

William O’Neill, MD, reviews RECOVER III study data showing improved outcomes associated with best practices, notably, improved survival in patients with AMI cardiogenic shock associated with adoption of best practice protocols in post-PMA vs pre-PMA cohorts:

• Earlier shock recognition and initiation of Impella® support
• Less use of inotropes and vasopressors
• More Impella pre-PCI and complete revascularization
• More use of right heart catheterization (RHC) to optimize therapy
• These led to a lower incidence of adverse events:
  • Less acute renal failure
  • Less bleeding requiring transfusion
  • Fewer vascular complications requiring surgery

Dr. O’Neill also introduces the RECOVER IV study, a randomized controlled trial in which patients with AMI cardiogenic shock will be randomized to the active treatment group using the National Cardiogenic Shock Initiative (NCSI) study protocol, or the control group, in which the patient will be treated with other treatment approaches, including any kind of circulatory support other than the Impella heart pump.

Dr. O’Neill is the medical director of the Center for Structural Heart Disease, Henry Ford System, Detroit, Michigan.