TCT-145 Relationship Between Preprocedural Blood Pressure and Outcomes in Patients Undergoing Impella-Supported High-Risk PCI: Insights From the cVAD PROTECT III Study
Recommended Citation
Bonnet G, Rommel K, Falah B, Lansky A, Zhang Y, Schonning M, Redfors B, Burkhoff D, Cohen D, Patel R, Basir MB, O’Neill WW, Granada J. TCT-145 Relationship Between Preprocedural Blood Pressure and Outcomes in Patients Undergoing Impella-Supported High-Risk PCI: Insights From the cVAD PROTECT III Study. 2023; :B56-B57.
Document Type
Conference Proceeding
Publication Date
10-24-2023
Abstract
Background: Temporary left ventricular assist devices (LVADs) are often used to prevent hypotension during high-risk percutaneous coronary intervention (HRPCI). The impact of preprocedural blood pressure (BP) on outcomes during HRPCI is unknown. Methods: Patients from the cVAD PROTECT III study undergoing Impella-supported HRPCI were divided based on preprocedural BP. Procedural outcomes included hypotensive episodes and in-hospital death. Clinical endpoints were 90-day major adverse cardiovascular and cerebrovascular events (MACCE: all-cause death, myocardial infarction, stroke/transient ischemic attack, and repeated revascularization) and 1 year mortality. Results: Patients (n = 1,159) who underwent Impella-supported HRPCI with baseline BP were evaluated: mean arterial pressure (MAP) >100 mm Hg (n = 242), >90-100 mm Hg (n = 264), >80-90 mm Hg (n = 306), and ≤80 mm Hg (n = 347). Lower preprocedural MAP was associated with baseline anemia, history of heart failure, left main disease, and transfer from another hospital. In-hospital and procedural outcomes did not differ between groups. However, 90-day MACCE rates and 1-year mortality increased with decreasing baseline BP levels (Figure 1). The association between BP category and 1-year mortality remained significant after adjustment (P < 0.001). [Formula presented] Conclusion: In a cohort of protected HRPCI with Impella, procedural hemodynamic stability was high. Although there was no association between baseline BP levels and in-hospital outcomes, lower preprocedural BP was associated with higher rates of 1-year mortality, which was related to differences in baseline clinical characteristics. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)
First Page
B56-B57
