
A recent multi-center cohort study investigated the optimal anticoagulation regime for percutaneous mechanical circulatory support (pMCS) using Impella™ in cardiogenic shock. The study, involving 170 patients, compared bleeding and thrombotic events in centers adopting therapeutic range (TR-aPTT) activated partial thromboplastin time (60–80s) and those with intermediate range aPTT (40–60s). The results indicate that a lower UFH target in left-Impella™ supported cardiogenic shock patients may reduce major bleedings without increasing major cardiovascular and cerebrovascular adverse events (MACCE). Further validation through larger, randomized clinical trials is warranted.
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