{"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":1782408461523,"version":"3.54.5"},"reference-count":27,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,13]],"date-time":"2023-05-13T00:00:00Z","timestamp":1683936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>(1) Background: Percutaneous left ventricle assist devices (pLVADs) demonstrated an improvement in mid-term clinical outcomes in selected patients with severely depressed left ventricular ejection fraction (LVEF) undergoing percutaneous coronary interventions. However, the prognostic impact of in-hospital LVEF recovery is unclear. Accordingly, the present sub-analysis aims to evaluate the impact of LVEF recovery in both cardiogenic shock (CS) and high-risk percutaneous coronary intervention (HR PCI) supported with pLVADs in the IMP-IT registry. (2) Methods: A total of 279 patients (116 patients in CS and 163 patients in HR PCI) treated with Impella 2.5 or CP in the IMP-IT registry were included in this analysis, after excluding those who died while in the hospital or with missing data on LVEF recovery. The primary study objective was a composite of all-cause death, rehospitalisation for heart failure, left ventricle assist device (LVAD) implantation, or heart transplantation (HT), overall referred to as the major adverse cardiac events (MACE) at 1 year. The study aimed to evaluate the impact of in-hospital LVEF recovery on the primary study objective in patients treated with Impella for HR PCI and CS, respectively. (3) Results: The mean in-hospital change in LVEF was 10 \u00b1 1% (p &lt; 0.001) in the CS cohort and 3 \u00b1 7% (p &lt; 0.001) in the HR PCI group, achieved by 44% and 40% of patients, respectively. In the CS group, patients with less than 10% in-hospital LVEF recovery experienced higher rates of MACE at 1 year of follow-up (FU) (51% vs. 21%, HR 3.8, CI 1.7\u20138.4, p &lt; 0.01). After multivariate analysis, LVEF recovery was the main independent protective factor for MACE at FU (HR 0.23, CI 0.08\u20130.64, p = 0.02). In the HR PCI group, LVEF recovery (&gt;3%) was not associated with lower MACE at multivariable analysis (HR 0.73, CI 0.31\u20131.72, p = 0.17). Conversely, the completeness of revascularisation was found to be a protective factor for MACE (HR 0.11, CI 0.02\u20130.62, p = 0.02) (4) Conclusions: Significant LVEF recovery was associated with improved outcomes in CS patients treated with PCI during mechanical circulatory support with Impella, whereas complete revascularisation showed a significant clinical relevance in HR PCI.<\/jats:p>","DOI":"10.3390\/jpm13050826","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T02:56:57Z","timestamp":1684119417000},"page":"826","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of in-Hospital Left Ventricular Ejection Fraction Recovery on Long-Term Outcomes in Patients Who Underwent Impella Support for HR PCI or Cardiogenic Shock: A Sub-Analysis from the IMP-IT Registry"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0571-3918","authenticated-orcid":false,"given":"Mario","family":"Iannaccone","sequence":"first","affiliation":[{"name":"Department of Cardiology, San Giovanni Bosco Hospital, 10100 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Franchin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, San Giovanni Bosco Hospital, 10100 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6569-9401","authenticated-orcid":false,"given":"Francesco","family":"Burzotta","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita\u0300 Cattolica del Sacro Cuore, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-482X","authenticated-orcid":false,"given":"Giulia","family":"Botti","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20100 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Pazzanese","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, 20100 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Briguori","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Mediterranea Cardiocentro, 80100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Trani","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita\u0300 Cattolica del Sacro Cuore, 00100 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0791-2235","authenticated-orcid":false,"given":"Tommaso","family":"Piva","sequence":"additional","affiliation":[{"name":"Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"De Marco","sequence":"additional","affiliation":[{"name":"Valvular and Structural Heart Cardiology, Centro Cardiologico Monzino, 20100 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Masiero","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Science, University of Padua, 35100 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Di Biasi","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Ospedale Luigi Sacco, 20100 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Pagnotta","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavino","family":"Casu","sequence":"additional","affiliation":[{"name":"Clinical and Interventional Cardiology, Sassari University Hospital, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Mara","family":"Scandroglio","sequence":"additional","affiliation":[{"name":"Advanced Heart Failure and Mechanical Circulatory Support Program, San Raffaele Scientific Institute, Vita Salute University, 20100 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Science, University of Padua, 35100 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaide","family":"Chieffo","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20100 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,13]]},"reference":[{"key":"ref_1","first-page":"E265","article-title":"Secular Trend in the Use and Implementation of Impella in High-Risk Percutaneous Coronary Intervention and Cardiogenic Shock: A Real-World Experience","volume":"31","author":"Wani","year":"2019","journal-title":"J. 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