Singh H, Mehta RH, O'Neill W, et al. - Researchers sought to compare clinical characteristics as well as results in patients experiencing acute myocardial infarction complicated by cardiogenic shock (AMICS) managed in the early experience with Impella percutaneous ventricular assist device and those treated recently. Risk adjusted in-hospital mortality was assessed as the primary endpoint. More invasive hemodynamic monitoring was received by the recent cohort and these patients had less use of an intra-aortic balloon pump prior to Impella. The recent cohort was identified to have significantly lower rates of acute kidney injury, major bleeding, and vascular complications necessitating surgery. Lower unadjusted in-hospital mortality was observed in relation to Impella use for AMICS during recent years, which likely indicates better patient selection, earlier device implantation, and improved management algorithms.