TCT-143 Prognostic Implications of Anemia in Impella-Supported HRPCI: Insights From the cVAD PROTECT III Study

Document Type

Conference Proceeding

Publication Date


Publication Title

J Am Coll Cardiol


Background: Anemia is prevalent among patients with cardiovascular disease and is associated with adverse outcomes. However, data regarding the impact of anemia in high-risk percutaneous coronary intervention (HRPCI) are limited. Methods: Patients undergoing Impella-supported HRPCI in the prospective multicenter cVAD PROTECT III study were assessed for anemia based on baseline hemoglobin levels according to the World Health Organization criteria. Patients were stratified into one of 3 groups (no anemia, mild anemia, and moderate or severe anemia). Major adverse cardiovascular and cerebrovascular events (MACCE: defined as all-cause death, myocardial infarction, stroke/transient ischemic attack, and repeated revascularization) at 30 and 90 days, and major bleeding events were analyzed based on baseline anemia status. Results: Of 1,072 patients, 62.0% (n = 665) had baseline anemia, with 18.7% (n = 200) having moderate or severe anemia. Anemic patients were older and more likely to have comorbidities. Anemia was associated with higher MACCE rates at 30 days (moderate to severe: 12.3%; mild: 9.8%; no anemia: 5.4%; P = 0.02) and 90 days (moderate to severe: 18.7%; mild: 14.6%; none: 8.3%; P = 0.004). Major bleeding at 30 days was higher in anemic patients (3.5% vs 1.2%; P = 0.03). [Formula presented] Conclusion: Baseline anemia in Impella-supported HRPCI predicts high risk of MACCE and major bleeding, emphasizing its significance as a prognostic factor. Whether specific management strategies can mitigate anemia-associated MACCE risk after HRPCI should be further studied. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)



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