{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:56:10Z","timestamp":1790898970833,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation Research"],"published-print":{"date-parts":[[2017,2,17]]},"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:underline>Rationale:<\/jats:underline>\n                    <\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) is common during high-risk percutaneous coronary intervention (PCI), particularly in those with severely reduced left ventricular ejection fraction. The impact of partial hemodynamic support with a microaxial percutaneous left ventricular assist device (pLVAD) on renal function after high-risk PCI remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:underline>Objective:<\/jats:underline>\n                    <\/jats:title>\n                    <jats:p>We tested the hypothesis that partial hemodynamic support with the Impella 2.5 microaxial pLVAD during high-risk PCI protected against AKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:underline>Methods and Results:<\/jats:underline>\n                    <\/jats:title>\n                    <jats:p>\n                      In this retrospective, single-center study, we analyzed data from 230 patients (115 consecutive pLVAD-supported and 115 unsupported matched-controls) undergoing high-risk PCI with ejection fraction \u226435%. The primary outcome was incidence of in-hospital AKI according to AKI network criteria. Logistic regression analysis determined the predictors of AKI. Overall, 5.2% (6) of pLVAD-supported patients versus 27.8% (32) of unsupported control patients developed AKI (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Similarly, 0.9% (1) versus 6.1% (7) required postprocedural hemodialysis (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05). Microaxial pLVAD support during high-risk PCI was independently associated with a significant reduction in AKI (adjusted odds ratio, 0.13; 95% confidence intervals, 0.09\u20130.31;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Despite preexisting CKD or a lower ejection fraction, pLVAD support protection against AKI persisted (adjusted odds ratio, 0.63; 95% confidence intervals, 0.25\u20130.83;\n                      <jats:italic>P<\/jats:italic>\n                      =0.04 and adjusted odds ratio, 0.16; 95% confidence intervals, 0.12\u20130.28;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:underline>Conclusions:<\/jats:underline>\n                    <\/jats:title>\n                    <jats:p>Impella 2.5 (pLVAD) support protected against AKI during high-risk PCI. This renal protective effect persisted despite the presence of underlying CKD and decreasing ejection fraction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circresaha.116.309738","type":"journal-article","created":{"date-parts":[[2017,1,10]],"date-time":"2017-01-10T22:10:20Z","timestamp":1484086220000},"page":"692-700","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":94,"title":["Hemodynamic Support With a Microaxial Percutaneous Left Ventricular Assist Device (Impella) Protects Against Acute Kidney Injury in Patients Undergoing High-Risk Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"120","author":[{"given":"Michael P.","family":"Flaherty","sequence":"first","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadip","family":"Pant","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir V.","family":"Patel","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Kilgore","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujith","family":"Dassanayaka","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Loughran","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasiq","family":"Rawasia","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buddhadeb","family":"Dawn","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Cheng","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo R.","family":"Bartoli","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine, University of Louisville School of Medicine, KY (M.P.F., S.P., T.K., S.D., J.H.L., W.R.); Internal Medicine, Sparks Regional Medical Center, Fort Smith, AR (S.V.P.); Cardiology, University of Kansas Medical Center, Kansas City (B.D.); Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO (A.C.); and Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (C.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.12.001"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2008.11.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02663-3"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.112.975888"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.03.086"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.098194"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12080"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06210612"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.06.016"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2011.02.002"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.1202"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.039909"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.12.005"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc5713"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.9.987"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20339"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp292"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.08.009"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.10.037"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1159\/000346096"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.09.018"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.06.068"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.10.007"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.007"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu366"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu278"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20380"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00084-6"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-009-0006-4"},{"key":"e_1_3_3_31_2","first-page":"91","article-title":"Use of Impella Recover\u00ae LP 2.5 left ventricular assist device during high-risk percutaneous coronary interventions; 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