Coronary disease & ACSSecondary analysis
Impact of Left Ventricular Unloading on Hemodynamics and Stunning in Complex Percutaneous Coronary Intervention (PCI)
- Secondary analysis of the CHIP-BCIS3 randomised trial
- prespecified substudy
Authors' conclusion
In patients undergoing complex PCI, elective LV unloading with mAFP reduced inotrope requirements but increased LOPP and did not prevent myocardial stunning.
Study context
- Population
- Patients with severe left ventricular (LV) systolic dysfunction undergoing complex PCI125 eligible
- Participants
- 97 patients
- Comparison
- Elective LV unloading with microaxial flow pump (mAFP) vs standard care
- mAFPn = 50
- Standard caren = 47reference
- Primary endpoint
- Coprimary: SBP reduction, loss of pulse pressure (LOPP), requirement for inotropes
Primary result
As reported in the abstract
mAFP vs Standard careRelative risk (95% CI)
SBP reduction
0.86(0.58–1.29)
inotrope use
0.57(0.34–0.97)
LOPP
7.83(2.53–24.24)
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Peri-procedural myocardial injury associated with LOPP · association of LOPP with peri-procedural myocardial injury | 3.00 (1.00–9.03) | ||
| 0.10.31310Odds ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Change in cardiac index · −0.25 vs −0.24 L/min/m² | P = 0.20 | |
| Change in pulmonary capillary wedge pressure · 2 vs 3 mm Hg | P = 0.79 |
Change in cardiac index
- Changes in cardiac index similar between groups
Change in pulmonary capillary wedge pressure
- Changes in PCWP similar between groups
Original publication
Impact of Left Ventricular Unloading on Hemodynamics and Stunning in Complex PCI. J Am Coll Cardiol. Published 5 August 2026. doi:10.1016/j.jacc.2026.06.041
Summarised from the published abstract; every number is checked against it