Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
July 28, 2026 · via Europe PMC
One-Year Outcomes of High-Risk Percutaneous Coronary Interventions With Versus Without Mechanical Circulatory Support: Propensity Score-Matched Analysis.
Gąsecka A, Pietrasik A, Pawłowski T, +13 more, Gąsior M.
AI summary — for doctors, generated from the abstract only
Patients who had Impella-supported high-risk PCI had similar 1-year survival and fewer myocardial infarctions than propensity-matched patients treated without mechanical circulatory support, despite a worse risk profile.
What was studied
Propensity-matched comparison of 138 patients from the IMPELLA-PL registry with controls from the retrospective CardioSilesia registry, assessing 1-year post-discharge death, MI, stroke, heart failure rehospitalisation and repeat revascularisation.
Key findings
- Clinical and angiographic characteristics were comparable overall, but some factors differed, such as dyslipidemia (78.3% vs 37.7%)
- Per the conclusion, 1-year post-discharge survival was similar between groups and MI was less frequent with Impella
- Event rates, hazard ratios and p-values are cut off in the abstract
Clinical relevance
Suggests Impella support may be reasonable in selected high-risk PCI cases, but this does not establish benefit over unsupported PCI.
Who should care
Limitations
Observational comparison across two different registries with possible residual confounding, imbalance in some risk factors, and truncated results with no numbers for the key outcomes.
Outcomes with Impella were at least comparable, but randomised trials are needed to confirm any advantage.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Impella is increasingly used as mechanical circulatory support (MCS) during high-risk percutaneous coronary interventions (HR-PCI). Registry-based data provide insights into the efficacy and safety of Impella-assisted HR-PCI.
Aims
We aimed to evaluate 1-year outcomes of Impella-assisted HR-PCI compared to HR-PCI without MCS.
Methods
One hundred and thirty-eight patients undergoing Impella-assisted PCI, included in the IMPELLA-PL registry, were propensity score-matched with controls from the retrospective CardioSilesia registry who underwent HR-PCI without MCS. Study endpoints included 1-year post-discharge all-cause mortality, myocardial infarction (MI), stroke, rehospitalization for heart failure (HF), and repeat coronary revascularization.
Results
Clinical and angiographic characteristics were comparable in both groups, with higher rates of dyslipidemia (78.3% vs. 37.7%, p < 0.001), chronic kidney disease (39.9% vs. 16.7%, p < 0.001), and peripheral artery disease (34.1% vs. 8.0%, p < 0.001) in the IMPELLA-PL cohort. Intravascular ultrasound was more frequently used in the Impella-supported patients (44.2% vs. 25.4%, p = 0.002), while staged revascularization was more common among controls (30.4% vs. 15.9%, p = 0.007). At 1 year, rates of post-discharge all-cause mortality, stroke, and repeat coronary revascularization were similar in both groups. MI was less frequent in the IMPELLA-PL cohort (1.4% vs. 10.9%, p = 0.003), alongside a trend toward lower incidence of rehospitalizations for HF (9.4% vs. 18.1%, p = 0.055).
Conclusions
Despite an unfavorable cardiovascular risk profile, patients who underwent Impella-assisted HR-PCI had similar 1-year post-discharge survival, with a lower rate of MI, compared to propensity score-matched controls who underwent HR-PCI without MCS. Impella may improve HR-PCI outcomes in selected patients, but further randomized controlled trials are required to confirm this finding.
DOI
10.1002/ccd.70749
PMID
42516021
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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