Short-and long-term outcomes of Impella-protected, high-risk, elective PCI in patients with multivessel coronary disease and low ejection fraction — Polish Impella Registry

Abstract

Background: The Impella percutaneous mechanical circulatory support device provides improved support in treating patients with high-risk percutaneous coronary interventions (HR-PCI) or in car-diogenic shock. IMPELLA-PL is a multicenter registry developed to share clinical data and experiences using Impella technology in Poland. The retrospective analysis conducted in this study aims to fill the knowledge gap of Impella performance in patients with multivessel coronary artery disease (CAD) and depressed left ventricular ejection fraction (EF) (≤ 30%) treated with HR-PCI. Methods: Retrospective data were analyzed from patients presenting with multivessel coronary disease and low EF treated with Impella CP collected from 20 Polish interventional cardiology centers registered with IMPELLA-PL to assess the safety and efficacy in short-and long-term clinical outcomes. Results: A total of 115 patients with low EF received Impella CP support during HR-PCI. The suc-cess rate of Impella supported HR-PCI was high (99.1%) with an average hospital stay of 15.6 ± 10.7 days. The right femoral artery was the most common access (55.7%) followed by the left femoral artery (37.4%). The in-hospital mortality rate was 6.1%, and the all-cause mortality rate at one year was 13.9%. Conclusions: High-risk PCI with Impella CP periprocedural support was safe and effective in patients with low EF (≤ 30%). The all-cause mortality rate (6.1% and 13.9%, respectively, for in-hospital and at 12-months) was comparable with other Impella registries.