{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:31:13Z","timestamp":1790616673001,"version":"4.1.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients undergoing high\u2010risk percutaneous coronary intervention, Impella has become an important adjunctive tool to support revascularization. The impact of age on the outcomes of patients undergoing high\u2010risk percutaneous coronary intervention is limited. The aim of this study is to describe the characteristics and outcomes of patients \u226575\u2009years of age undergoing Impella\u2010supported high\u2010risk percutaneous coronary intervention.<\/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                      Baseline characteristics and outcomes of patients \u226575\u2009years of age versus those of patients &lt;75\u2009years of age in patients enrolled in the cVAD PROTECT III (Catheter\u2010Based Ventricular Assist Device Prospective, Multi\u2010Center, Randomized Controlled Trial of the IMPELLA RECOVER LP 2.5 System Versus Intra Aortic Balloon Pump in Patients Undergoing Non Emergent High Risk Percutaneous Coronary Intervention) study (NCT04136392). Major adverse cardiovascular and cerebral events (composite of all\u2010cause death, nonfatal myocardial infarction, stroke\/transient ischemic attack, and repeat revascularization) were assessed at 30 and 90\u2009days and all\u2010cause death at 1\u2009year. Out of 1237 patients, 493 (39.9%) patients were \u226575\u2009years of age. Patients \u226575\u2009years of age had less diabetes and prior myocardial infarction, more hypertension and dyslipidemia, worse renal function, more severe valvular heart disease, but higher left ventricular ejection fraction (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05 for all comparisons). Baseline Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores were similar between groups. Older patients underwent more left main percutaneous coronary intervention (58% versus 39%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001), atherectomy (32% versus 22%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001), and femoral access (87% versus 79%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.0003) as compared with younger patients. In\u2010hospital vascular complications did not differ, but rates of respiratory failure, pericardial tamponade, and cardiogenic shock were higher in older patients. Rates of all\u2010cause death and major adverse cardiovascular and cerebral events did not differ between groups at 30 and 90\u2009days. Rates of all\u2010cause death at 1\u2009year were higher in patients \u226575\u2009years (adjusted hazard ratio, 1.99 [95% CI, 1.24\u20133.18],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Impella\u2010supported high\u2010risk percutaneous coronary intervention in older patients is feasible with an acceptable safety profile. However, age \u226575\u2009years remained a statistically significant predictor for all\u2010cause death at 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique Identifier: NCT04136392.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.038509","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T23:37:16Z","timestamp":1744846636000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Characteristics and Outcomes of Older Patients Undergoing Protected Percutaneous Coronary Intervention With Impella"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2443-6090","authenticated-orcid":false,"given":"Philipp","family":"Jakob","sequence":"first","affiliation":[{"name":"University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8002-7497","authenticated-orcid":false,"given":"Alexandra J.","family":"Lansky","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine","place":["New Haven, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3486-6753","authenticated-orcid":false,"given":"Mir B.","family":"Basir","sequence":"additional","affiliation":[{"name":"Henry Ford Health System","place":["Detroit, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0624-3332","authenticated-orcid":false,"given":"Michael J.","family":"Schonning","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6709-0840","authenticated-orcid":false,"given":"Batla","family":"Falah","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3016-1150","authenticated-orcid":false,"given":"Wayne B.","family":"Batchelor","sequence":"additional","affiliation":[{"name":"Inova Heart and Vascular Institute","place":["Falls Church, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0626-6649","authenticated-orcid":false,"given":"Arsalan","family":"Abu\u2010Much","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1653-6443","authenticated-orcid":false,"given":"Cindy L.","family":"Grines","sequence":"additional","affiliation":[{"name":"Northside Hospital Cardiovascular Institute","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5896-728X","authenticated-orcid":false,"given":"William W.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Henry Ford Health System","place":["Detroit, 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