000			03593nam a22004937a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
024			_aS0002-9149(24)00423-5 [pii]
040			_aOvid MEDLINE(R)
099			_a38871158
245			_aImpella Versus Non-Impella for Nonemergent High-Risk Percutaneous Coronary Intervention.
251			_aAmerican Journal of Cardiology. 2024 Jun 12
252			_aAm J Cardiol. 2024 Jun 12
253			_aThe American journal of cardiology
260			_c2024
260			_fFY2024
260			_p2024 Jun 12
265			_saheadofprint
265			_tPublisher
266			_d2024-08-07
266			_z2024/06/13 19:27
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aThe benefit of mechanical circulatory support with Impella (Abiomed, Inc., Danvers, Massachusetts) for high-risk percutaneous coronary intervention (HR-PCI) is uncertain. PROTECT III registry data showed improved outcomes with Impella compared with historical data (PROTECT II) but lacks a direct comparison with the HR-PCI cohort without Impella support. We retrospectively identified patients meeting the PROTECT III inclusion criteria for HR-PCI and compared this group (non-Impella cohort [NonIMP]) with the outcomes data from the PROTECT III registry (Impella cohort). Baseline differences were balanced using inverse propensity weighting. The coprimary outcome was major adverse cardiac events (MACE) in-hospital and at 90 days. A total of 283 patients at great risk did not receive Impella support; 200 patients had 90-days event ascertainment and were included in the inverse propensity weighting analysis and compared with 504 patients in the Impella cohort group. After calibration, few residual differences remained between groups. The primary outcome was not different in-hospital (3.0% vs 4.8%, p=0.403) but less in NonIMP at 90 days (7.5% vs 13.8%, p=0.033). Periprocedural vascular complications, bleeding, and transfusion rate did not differ between groups; however, acute kidney injury occurred more frequently in the NonIMP group (10.5% vs 5.4%, p=0.023). In conclusion, under identical HR-PCI inclusion criteria for Impella use in PROTECT III, an institutional non-Impella-supported HR-PCI cohort showed similar MACE in-hospital but fewer MACE at 90 days, whereas there was no signal for periprocedural harm with Impella use. These results do not support routine usage of Impella for patients with HR-PCI. Copyright © 2024 Elsevier Inc. All rights reserved.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aAdvanced Cardiac Catheterization Research Fellowship
657			_aJournal Article
700			_aBen-Dor, Itsik _bMHVI
700			_aBernardo, Nelson L _bMHVI
700			_aCellamare, Matteo _bMHVI
700			_aHashim, Hayder _bMHVI
700			_aMerdler, Ilan _bMHVI
700			_aReddy, Pavan _bMWHC _cAdvanced Cardiac Catheterization Research Fellowship _dMD
700			_aRogers, Toby _bMHVI
700			_aSatler, Lowell F _bMHVI
700			_aWaksman, Ron _bMHVI
700			_aZhang, Cheng _bMHVI
790			_aReddy P, Merdler I, Zhang C, Cellamare M, Ben-Dor I, Bernardo NL, Hashim H, Satler LF, Rogers T, Waksman R
856			_uhttps://dx.doi.org/10.1016/j.amjcard.2024.05.038 _zhttps://dx.doi.org/10.1016/j.amjcard.2024.05.038
942			_cART _dArticle
999			_c14367 _d14367