Heart failure & cardiomyopathies
Percutaneous ventricular assist devices for percutaneous coronary interventions in older patients with heart failure: a target trial emulation
Authors' conclusion
This observational study using the Medicare databases in the USA did not find evidence that clinical outcomes differed between older patients with systolic HF receiving PCI with pVAD vs PCI plus IABP.
Study context
- Population
- Medicare fee-for-service beneficiaries aged 65–99 years with systolic heart failure (HF) receiving percutaneous coronary interventions (PCI) from 2017 to 20202,096 patients matched
- Participants
- 5,823 beneficiaries
- Exposure
- PCI plus percutaneous ventricular assist devices (pVAD) versus PCI plus intra-aortic balloon pump
Methodological detailsobservational study, propensity score matching, Cox regression model
- Observational study
- Propensity score matching
- Cox regression model
Main finding
As reported in the abstract
MACE:
- Composite of all-cause mortality
- HF readmission
- Acute myocardial infarction
- Stroke
Adjusted hazard ratio
0.95
95% CI 0.83–1.10
By group
pVAD group vs IABP group
aHR 0.95 (95% CI 0.83–1.10)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Mortality · 1 year | 0.94 (0.79–1.12) | |
| 0.512Adjusted hazard ratio (log scale) |
Sensitivity analyses
- Findings consistent across several sensitivity analyses
Safety
| Outcome | Adjusted risk ratio (95% CI) | |
|---|---|---|
| Postprocedural transfusions · in-hospital | 1.07 (0.75–1.52) | |
| 0.512Adjusted risk ratio (log scale) |
Original publication
Percutaneous ventricular assist devices for percutaneous coronary interventions in older patients with heart failure: a target trial emulation. Heart. Published 11 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it