{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T09:39:05Z","timestamp":1769074745259,"version":"3.49.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The use of mechanical circulatory support devices for high\u2010risk percutaneous coronary intervention (PCI) has increased over the past decade despite limited data of benefit. We sought to examine the association between intravascular microaxial left ventricular assist device (LVAD) versus intra\u2010aortic balloon pump use in patients without cardiogenic shock (CS) undergoing PCI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This retrospective study analyzed claims data from a large, insured population who underwent PCI without CS from April 1, 2016 to July 31, 2022. Using inverse probability treatment weighting, we assessed for the association between device type and clinical outcomes. The primary outcome was all\u2010cause mortality. Secondary outcomes included stroke, bleeding, incident dialysis, repeat revascularization, and total health care costs during the index admission and at 30\u2009days. We identified 2879 patients without CS who underwent PCI with either an intra\u2010aortic balloon pump or microaxial LVAD. The mean\u00b1SD age was 68.2\u00b112.5\u2009years, and 27% (n=764) were women. After propensity weighting, intravascular LVAD use was not associated with a significant difference in either in\u2010hospital (odds ratio [OR] 1.30 [95% CI, 0.88\u20131.91];\n              <jats:italic>P<\/jats:italic>\n              =0.19) or 30\u2010day mortality (OR, 1.19 [95% CI, 0.84\u20131.69];\n              <jats:italic>P<\/jats:italic>\n              =0.33) compared with intra\u2010aortic balloon pump use. Compared with those receiving an intra\u2010aortic balloon pump, the mean total costs for the index admission ($96\u2009716 versus $71\u2009892;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and at 30\u2009days (+$16\u2009671 [95% CI, $6639\u2013$28\u2009103];\n              <jats:italic>P<\/jats:italic>\n              =0.001) were significantly higher in those receiving an intravascular LVAD. There was no significant association between device type and stroke, bleeding, incident dialysis, and repeat revascularization at any time point (all\n              <jats:italic>P<\/jats:italic>\n              &gt;0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In patients without CS undergoing PCI, intravascular LVAD use was associated with higher costs but not associated with lower mortality. Randomized data are needed to improve device selection for patients without CS undergoing PCI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.037424","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T11:18:19Z","timestamp":1736507899000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Mechanical Circulatory Support in Patients Without Cardiogenic Shock Undergoing Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-1492","authenticated-orcid":false,"given":"P. Elliott","family":"Miller","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4565-0771","authenticated-orcid":false,"given":"Aliza S.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Public Policy Institute, Elevance Health Indianapolis IN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Public Policy Institute, Elevance Health Indianapolis IN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7596-4697","authenticated-orcid":false,"given":"Tariq","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha G.","family":"Bromfield","sequence":"additional","affiliation":[{"name":"Public Policy Institute, Elevance Health Indianapolis IN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4784-4513","authenticated-orcid":false,"given":"Saket","family":"Girotra","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos D.","family":"Davila","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey","family":"Crawford","sequence":"additional","affiliation":[{"name":"Medical Policy &amp; Technology Assessment Elevance Health Indianapolis IN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0280-0082","authenticated-orcid":false,"given":"John","family":"Whitney","sequence":"additional","affiliation":[{"name":"Medical Policy &amp; Technology Assessment Elevance Health Indianapolis IN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2384-2545","authenticated-orcid":false,"given":"Nihar R.","family":"Desai","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.121.011534"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.121.011778"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312572"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2022.2735"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.026"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0254"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2022.02.006"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.058229"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.098194"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001039"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2022.08.032"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.037424","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T12:05:28Z","timestamp":1737547528000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.037424"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,1,21]]}},"alternative-id":["10.1161\/JAHA.124.037424"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.037424","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]},"assertion":[{"value":"2024-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e037424"}}