TCT-574 Safety and Efficacy of Percutaneous Ventricular Assist Device Versus Intra-Aortic Balloon Pump Supported High-Risk Percutaneous Coronary Intervention (HRPCI)
Recommended Citation
Shah T, Holy C, Moses J, Parise H, Lemor A, O’Neill W, Lansky A. TCT-574 Safety and Efficacy of Percutaneous Ventricular Assist Device Versus Intra-Aortic Balloon Pump Supported High-Risk Percutaneous Coronary Intervention (HRPCI). J Am Coll Cardiol 2024; 84(18):B210.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: We compare outcomes between Impella percutaneous ventricular assist device (PVAD) vs intra-aortic balloon pump (IABP)-supported high-risk percutaneous coronary intervention (HRPCI) in a large-scale, contemporary claims dataset. Methods: Patients undergoing HRPCI supported by PVAD or IABP between January 2018 and April 2024 were identified in the Premier Healthcare Database. Patients were excluded if they had cardiogenic shock or STEMI on admission, required emergent procedures, had multiple mechanical circulatory support devices used, or underwent coronary artery bypass graft surgery within the same admission. Variable rate propensity score matching was performed using logistic regression of 87 preprocedural variables (identified by statistical importance) including patient demographics, comorbidities, prior procedures, prior complications, and provider/hospital factors. The primary endpoint was 90-day mortality while secondary endpoints included MACE (defined as myocardial infarction [MI], stroke, or death), new cardiogenic shock, acute kidney injury, cardiovascular-related bleeding, in-hospital bleeding requiring transfusions, length of stay, and discharge disposition. Results: A total of 4,879 patients (3,925 PVAD and 954 IABP) met inclusion criteria. Among these, 2,511 PVAD patients and 879 IABP patients undergoing HRPCI were matched. Mortality and MACE at 90 days and postprocedural cardiogenic shock and 30-day acute kidney injury were lower with PVAD compared with IABP support (Table 1). PVAD patients had shorter lengths of stay and were more likely to be discharged to home. There were no significant differences in rates of bleeding in either group. [Formula presented] Conclusion: This observational study suggests that PVAD-assisted HRPCI is associated with improved postprocedural hemodynamics and 90-day clinical outcomes without a significant increased risk of bleeding compared with IABP support. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP).
Volume
84
Issue
18
First Page
B210
