TABLE 5.
Baseline, procedural and In‐Hospital management characteristics stratified by timing of insertion of Impella 2.5 and CP in relation to PCI in patients with high‐risk PCI
| Overall (N = 174) | Before (N = 117) | During/after (N = 57) | p‐value | |
|---|---|---|---|---|
| Age | 73 [66;80] | 72 [66;81] | 76 [69;80] | .42 |
| Male | 83% (145) | 87% (102) | 75% (43) | .09 |
| Hypertension | 82% (143) | 84% (98) | 79% (45) | .51 |
| Dyslipidemia | 61% (106) | 62% (72) | 60% (34) | .87 |
| Diabetes mellitus | 46% (80) | 47% (55) | 44%25 | .75 |
| COPD | 20% (35) | 16%19 | 30%16 | .06 |
| Prior MI | 42% (73) | 38% (44) | 51% (29) | .10 |
| Prior PCI | 24% (42) | 21%24 | 32%18 | .13 |
| Prior CABG | 15% (26) | 14%16 | 18%10 | .65 |
| CKDa | 38% (66) | 36% (42) | 43%24 | .40 |
| AF | 17% (29) | 17%20 | 16%9 | 1 |
| Prior TIA/stroke | 11%19 | 10%12 | 12%7 | .79 |
| PAD | 25% (44) | 27% (32) | 21%12 | .46 |
| Chronic HF | 54% (94) | 56% (66) | 50% (28) | .51 |
| LVEF, % | 30 [25;35] | 30 [25;35] | 30 [25;37] | .42 |
| RV dysfunction | 13%21 | 10%12 | 18%9 | .20 |
| Out of hospital cardiac arrest | 1%2 | 1%1 | 2%1 | 1 |
| Laboratory values | ||||
| Ph | 7.40 [7.38;7.45] | 7.45 [7.38;7.45] | 7.40 [7.34;7.44] | .82 |
| HR (bpm) | 75 [69;86] | 77 [70;86] | 74 [68;86] | .48 |
| MAP | 80 [75;90] | 80 [75;90] | 78 [69;90] | .10 |
| Baseline lactate (mmol/l) | 1.5 [1;1.9] | 1.4 [1;1.8] | 1.8 [1.2;2.1] | .10 |
| Baseline hemoglobin (g/dl) | 12.4 [11.3;13.7] | 12.3 [11.4;13.3] | 12.9 [11.3;14] | .14 |
| Baseline creatinine (mg/dl) | 1 [0.8;1.4] | 0.9 [0.8;1.4] | 1.1 [0.9;1.4] | .04 |
| Procedural characteristics | ||||
| PCI performed | 99% (173) | 99% (117) | 100% (56) | 1 |
| Number of diseased vessels | 3 [2;3] | 3 [2;3] | 3 [2;3] | .05 |
| Three vessels disease | 68% (119) | 72% (84) | 61% (35) | .22 |
| BCIS myocardial jeopardy score | 12 [10;12] | 12 [10;12] | 12 [9;16] | .27 |
| Left Main stenosis | 48% (81) | 49% (57) | 46%24 | .73 |
| LAD stenosis | 94% (159) | 97% (113) | 87% (46) | .01 |
| CX stenosis | 88% (147) | 92% (107) | 78% (40) | .02 |
| RCA stenosis | 81% (136) | 85% (99) | 73% (37) | .06 |
| By‐pass stenosis | 10%16 | 8%9 | 14%7 | .41 |
| Number of treated vessels | 1.9 ± 0.9 | 2 ± 0.8 | 1.6 ± 1.0 | <.01 |
| Three vessels treated | 25% (41) | 27% (30) | 21%11 | .46 |
| Rotablator | 25% (43) | 22%25 | 32%18 | .21 |
| Resuscitation required during index procedure | 4%6 | 2%2 | 7%4 | .07 |
| Resuscitation required after index procedure | 4%7 | 3%3 | 7%4 | .23 |
| In‐hospital management | ||||
| Impella removed immediately after PCI | 83% (141) | 83% (96) | 83% (45) | 1 |
| Duration of support (hours) | 1.5 [1.5;3] | 2 [1.5;3] | 1.5 [1.5;2.4] | .49 |
| Use of Impella 2.5 | 62% (108) | 61% (71) | 65% (37) | .61 |
| Use of Impella CP | 38% (66) | 39% (46) | 35%20 | .64 |
| Other cardiopulmonary support used | ||||
| Inotropes | 8%14 | 9%10 | 8%4 | 1 |
| Mechanical ventilation | 17% (29) | 21%24 | 9%5 | .09 |
| ECMO | 0% (0) | 0% (0) | 0% (0) | NA |
| IABP | 2%3 | 3%3 | 0% (0) | .55 |
Note: Results reported as n (%) for categorical variables and median (interquartile range) or mean ± SD for continuous variables as appropriate.
Abbreviations: AF, atrial fibrillation; BCIS, British Cardiovascular Intervention Society; CABG, coronary artery by‐pass graft; CKD, chronic kidney disease; COPD, Chronic pulmonary disease; Cx, circumflex coronary artery; ECMO, ExtraCorporeal Membrane Oxygenation; HF, heart failure; HR, heart rate; IABP, intra‐aortic balloon pump; LAD, left descending artery; LVEF, left ventricular ejection fraction; MAP, mean arterial pressure; MI, myocardial infarction; PAD, peripheral artery disease; PCI, percutaneous coronary intervention; RCA, right coronary artery; RV, right ventricular; TIA, transient ischemic attack.
Defined as eGFR <60 ml/min/1.73 m2.