100.66 Percutaneous Ventricular Assist Device Supported Elective Percutaneous Coronary Intervention Performed in Sicker, More Complex Patients Compared to Intra-Aortic Balloon Pump

Document Type

Conference Proceeding

Publication Date

2-1-2024

Publication Title

JACC Cardiovasc Interv

Abstract

Background: Observational studies comparing patients undergoing elective percutaneous coronary intervention (PCI) with percutaneous ventricular assist device (pVAD) or intra-aortic balloon pump (IABP) have shown disparate results. We compared patient and procedural characteristics of IABP and pVAD-supported PCI populations. Methods: Patients undergoing elective PCI with pVAD or IABP support in the PREMIER database (2018-2022) were identified. Exclusion criteria included isolated right heart failure, cardiogenic shock and/or STEMI on admission, coronary artery bypass graft surgery at index and pVAD and IABP use within same admission. Propensity scores (PS) were estimated using logistic regression and distributions of PS were compared between pVAD and IABP cohorts to assess baseline comparability on measured covariates. Results: 3,098 and 799 patients with PVAD- and IABP were analyzed. PVAD vs IABP patients had older mean age (72.6 vs 71.1) and significantly more comorbidities: congestive heart failure (73% vs 57%), renal failure (38% vs 32%), chronic total occlusion (24% vs 15%) and ischemic cardiomyopathy (46% vs 28%). For their actual PCI procedure: PVAD vs IABP was more likely to have 2 or more arteries dilated (51% vs 28%), and 3 or more arteries dilated (21% vs 11%). PS distributions showed limited overlap between cohorts. Conclusions: Among elective PCI patients, pVAD cases were older and sicker, with more arteries treated, vs IABP. Most pVAD cases were at the high end of the PS range, where there were relatively few IABP patients, suggesting limited comparability between groups. [Formula presented]

Volume

17

Issue

4

First Page

S19

Last Page

S20

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