{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:27:41Z","timestamp":1782408461819,"version":"3.54.5"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Prior studies have found that patients with chronic kidney disease (CKD) have worse outcomes following percutaneous coronary intervention (PCI). There are no data about patients with advanced CKD undergoing Impella-supported high-risk PCI. We, therefore, aimed to evaluate angiographic characteristics and clinical outcomes in patients with CKD who received Impella-supported high-risk PCI as part of the catheter-based ventricular assist device PROTECT III study (A Prospective, Multi-Center, Randomized Controlled Trial of the IMPELLA RECOVER LP 2.5 System Versus Intra Aortic Balloon Pump [IABP] in Patients Undergoing Non Emergent High Risk PCI).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Patients enrolled in the PROTECT III study were analyzed according to their baseline estimated glomerular filtration rate (eGFR). The primary outcome was 90-day major adverse cardiovascular and cerebrovascular events (the composite of all-cause death, myocardial infarction, stroke\/transient ischemic attack, and repeat revascularization).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Of 1237 enrolled patients, 1052 patients with complete eGFR baseline assessment were evaluated: 586 with eGFR \u226560 mL\/min per 1.73 m\n              <jats:sup>2<\/jats:sup>\n              , 190 with eGFR \u226545 to &lt;60, 105 with eGFR \u226530 to &lt;45, and 171 with eGFR &lt;30 or on dialysis. Patients with lower eGFR (all groups with eGFR &lt;60) were more frequently females and had a higher prevalence of hypertension, diabetes, anemia, and peripheral artery disease. The baseline Synergy Between PCI With Taxus and Cardiac Surgery score was similar between groups (28.2\u00b112.6 for all groups). Patients with lower eGFR were more likely to have severe coronary calcifications and higher usage of atherectomy. There were no differences in individual PCI\u2013related coronary complications between groups, but the rates of overall PCI complications were less frequent among patients with lower eGFR. Major adverse cardiovascular and cerebrovascular events at 90 days and 1-year mortality were significantly higher among patients with eGFR &lt;30 mL\/min per 1.73 m\n              <jats:sup>2<\/jats:sup>\n              or on dialysis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>\n              Patients with advanced CKD undergoing Impella-assisted high-risk PCI tend to have higher baseline comorbidities, severe coronary calcification, and higher atherectomy usage, yet CKD was not associated with a higher rate of immediate PCI\u2013related complications. However, 90-day major adverse cardiovascular and cerebrovascular events and 1-year mortality were significantly higher among patients with eGFR&lt;30 mL\/min per 1.73 m\n              <jats:sup>2<\/jats:sup>\n              or on dialysis. Future studies of strategies to improve intermediate and long-term outcomes of these high-risk patients are warranted.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04136392.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.123.013503","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T09:00:33Z","timestamp":1714986033000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Angiographic Characteristics and Clinical Outcomes in Patients With Chronic Kidney Disease Undergoing Impella-Supported High-Risk Percutaneous Coronary Intervention: Insights From the cVAD PROTECT III Study"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct04136392","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3911-0579","authenticated-orcid":true,"given":"Aditya S.","family":"Bharadwaj","sequence":"first","affiliation":[{"name":"Division of Cardiology, Loma Linda University Medical Center, CA (A.S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0626-6649","authenticated-orcid":true,"given":"Arsalan","family":"Abu-Much","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneel S.","family":"Maini","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8440-9337","authenticated-orcid":true,"given":"Yanru","family":"Li","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne B.","family":"Batchelor","sequence":"additional","affiliation":[{"name":"Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (W.B.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1653-6443","authenticated-orcid":true,"given":"Cindy L.","family":"Grines","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northside Hospital Cardiovascular Institute, Atlanta, GA (C.L.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8319-5637","authenticated-orcid":true,"given":"Suzanne J.","family":"Baron","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Boston (S.J.B.)."},{"name":"Baim Institute for Clinical Research, Boston, MA (S.J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4155-4451","authenticated-orcid":true,"given":"Bj\u00f6rn","family":"Redfors","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.)."},{"name":"Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8002-7497","authenticated-orcid":true,"given":"Alexandra J.","family":"Lansky","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine, New Haven, CT (A.J.L.)."},{"name":"Barts Heart Centre, Queen Mary University of London, United Kingdom (A.J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3486-6753","authenticated-orcid":true,"given":"Mir B.","family":"Basir","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI (M.B.B., W.W.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5896-728X","authenticated-orcid":true,"given":"William 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