Age-specific differences of Impella support in Japanese patients: The Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events

The association between the clinical significance and prognostic impact of catheter-based micro-axial ventricular assist device Impella (Abiomed, Danvers, MA, USA) support and age has not been sufficiently investigated. A total of 5282 patients treated with Impella were analyzed from the Japanese re...

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Veröffentlicht in:Journal of cardiology 2024-11
Hauptverfasser: Shirakabe, Akihiro, Matsushita, Masato, Shigihara, Shota, Nishigoori, Suguru, Sawatani, Tomofumi, Tani, Kenichi, Morooka, Masaki, Asai, Kuniya
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container_title Journal of cardiology
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creator Shirakabe, Akihiro
Matsushita, Masato
Shigihara, Shota
Nishigoori, Suguru
Sawatani, Tomofumi
Tani, Kenichi
Morooka, Masaki
Asai, Kuniya
description The association between the clinical significance and prognostic impact of catheter-based micro-axial ventricular assist device Impella (Abiomed, Danvers, MA, USA) support and age has not been sufficiently investigated. A total of 5282 patients treated with Impella were analyzed from the Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD). Patients were categorized into four age groups:
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A total of 5282 patients treated with Impella were analyzed from the Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD). Patients were categorized into four age groups: &lt;50 years old (Group A, n = 670), 50–69 years old (Group B, n = 2009), 70–79 years old (Group C, n = 1716), and ≥80 years old (Group D, n = 887). Kaplan–Meier curve analysis demonstrated that the prognosis, including 30-day all-cause mortality, was significantly poorer in Group D compared to the other groups. A multivariate Cox regression model identified Group D as an independent predictor of 30-day all-cause death (HR: 2.173, 95 % CI: 1.699–2.779) relative to Group A. The multivariate logistic regression analysis indicated that estimated glomerular filtration rate, lactate levels, and systolic blood pressure were independently associated with 30-day mortality across all age categories. The presence of more than two major adverse events was independently associated with 30-day mortality specifically in the cohort aged ≥80 years (OR: 1.492, 95 % CI: 1.037–2.148, p = 0.031). Increasing age was identified as a significant factor associated with higher 30-day mortality rates in J-PVAD. While the incidence of major adverse events did not differ significantly across age categories, the occurrence of two or more additional adverse events was linked to increased 30-day mortality among older individuals. Therefore, an appropriate mechanical support strategy may be necessary for elderly Japanese patients based on their age. [Display omitted] •The association between Impella support and age has not been investigated.•Total of 5,282 patients treated with Impella were analyzed from J-PVAD.•The prognosis, was significantly poorer in ≥80 years old.•The e-GFR, lactate, and systolic blood pressure were associated with mortality across all age categories.•More than two major adverse events were associated with mortality in those aged ≥80.</description><identifier>ISSN: 0914-5087</identifier><identifier>ISSN: 1876-4738</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2024.11.007</identifier><identifier>PMID: 39615836</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Acute decompensated heart failure ; Hemodynamics ; Liver function ; Mortality ; Plasma volume status</subject><ispartof>Journal of cardiology, 2024-11</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. 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A total of 5282 patients treated with Impella were analyzed from the Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD). Patients were categorized into four age groups: &lt;50 years old (Group A, n = 670), 50–69 years old (Group B, n = 2009), 70–79 years old (Group C, n = 1716), and ≥80 years old (Group D, n = 887). Kaplan–Meier curve analysis demonstrated that the prognosis, including 30-day all-cause mortality, was significantly poorer in Group D compared to the other groups. A multivariate Cox regression model identified Group D as an independent predictor of 30-day all-cause death (HR: 2.173, 95 % CI: 1.699–2.779) relative to Group A. The multivariate logistic regression analysis indicated that estimated glomerular filtration rate, lactate levels, and systolic blood pressure were independently associated with 30-day mortality across all age categories. The presence of more than two major adverse events was independently associated with 30-day mortality specifically in the cohort aged ≥80 years (OR: 1.492, 95 % CI: 1.037–2.148, p = 0.031). Increasing age was identified as a significant factor associated with higher 30-day mortality rates in J-PVAD. While the incidence of major adverse events did not differ significantly across age categories, the occurrence of two or more additional adverse events was linked to increased 30-day mortality among older individuals. Therefore, an appropriate mechanical support strategy may be necessary for elderly Japanese patients based on their age. [Display omitted] •The association between Impella support and age has not been investigated.•Total of 5,282 patients treated with Impella were analyzed from J-PVAD.•The prognosis, was significantly poorer in ≥80 years old.•The e-GFR, lactate, and systolic blood pressure were associated with mortality across all age categories.•More than two major adverse events were associated with mortality in those aged ≥80.</description><subject>Acute decompensated heart failure</subject><subject>Hemodynamics</subject><subject>Liver function</subject><subject>Mortality</subject><subject>Plasma volume status</subject><issn>0914-5087</issn><issn>1876-4738</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQhy0EokvhBTggH8shwXYcx0FcVi30jyq1QqVXy7EnxVESBztZad-Nh8NhW7j1ZGn8_WY8_hB6T0lOCRWfurzrjMkZYTynNCekeoE2VFYi41UhX6INqSnPSiKrI_Qmxo4QQWopXqOjoha0lIXYoN_bB8jiBMa1zmDr2hYCjAYi9i2-HCboe43jMk0-zNiN-EpPeoQIeNKzg3GOn_HdT_hf_g4PLs5hj1sf8C0Es8zpwi8R3yc6OLP0OuBtjInCZ7BzBvDJVXZ7vz37iMNTWI-63ycE-xH7ZTZ-SA_So8Xa7iCkMbBbZ79Fr1rdR3j3eB6jH9--3p1eZNc355en2-vM0JKJTDai0aY0JeHcWFs1tSa6ZGWZilLyooJGt5rVVgCrG2qZ5KxpaG2tlLbSojhGJ4e-U_C_FoizGlw069f8XU0VlBMpJat4QtkBNcHHGKBVU3CDDntFiVqtqU6t1tRqTVGqkrUU-vDYf2kGsP8iT5oS8OUAQNpy5yCoaNyqyboAZlbWu-f6_wE4hqzO</recordid><startdate>20241129</startdate><enddate>20241129</enddate><creator>Shirakabe, Akihiro</creator><creator>Matsushita, Masato</creator><creator>Shigihara, Shota</creator><creator>Nishigoori, Suguru</creator><creator>Sawatani, Tomofumi</creator><creator>Tani, Kenichi</creator><creator>Morooka, Masaki</creator><creator>Asai, Kuniya</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20241129</creationdate><title>Age-specific differences of Impella support in Japanese patients: The Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events</title><author>Shirakabe, Akihiro ; Matsushita, Masato ; Shigihara, Shota ; Nishigoori, Suguru ; Sawatani, Tomofumi ; Tani, Kenichi ; Morooka, Masaki ; Asai, Kuniya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1526-8b6bac5c5044cdd7b9a0a5255ac588437ebafa29d6e29b1d2842bb19dd88d7a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute decompensated heart failure</topic><topic>Hemodynamics</topic><topic>Liver function</topic><topic>Mortality</topic><topic>Plasma volume status</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shirakabe, Akihiro</creatorcontrib><creatorcontrib>Matsushita, Masato</creatorcontrib><creatorcontrib>Shigihara, Shota</creatorcontrib><creatorcontrib>Nishigoori, Suguru</creatorcontrib><creatorcontrib>Sawatani, Tomofumi</creatorcontrib><creatorcontrib>Tani, Kenichi</creatorcontrib><creatorcontrib>Morooka, Masaki</creatorcontrib><creatorcontrib>Asai, Kuniya</creatorcontrib><creatorcontrib>J-PVAD Investigators</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shirakabe, Akihiro</au><au>Matsushita, Masato</au><au>Shigihara, Shota</au><au>Nishigoori, Suguru</au><au>Sawatani, Tomofumi</au><au>Tani, Kenichi</au><au>Morooka, Masaki</au><au>Asai, Kuniya</au><aucorp>J-PVAD Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age-specific differences of Impella support in Japanese patients: The Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2024-11-29</date><risdate>2024</risdate><issn>0914-5087</issn><issn>1876-4738</issn><eissn>1876-4738</eissn><abstract>The association between the clinical significance and prognostic impact of catheter-based micro-axial ventricular assist device Impella (Abiomed, Danvers, MA, USA) support and age has not been sufficiently investigated. A total of 5282 patients treated with Impella were analyzed from the Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD). Patients were categorized into four age groups: &lt;50 years old (Group A, n = 670), 50–69 years old (Group B, n = 2009), 70–79 years old (Group C, n = 1716), and ≥80 years old (Group D, n = 887). Kaplan–Meier curve analysis demonstrated that the prognosis, including 30-day all-cause mortality, was significantly poorer in Group D compared to the other groups. A multivariate Cox regression model identified Group D as an independent predictor of 30-day all-cause death (HR: 2.173, 95 % CI: 1.699–2.779) relative to Group A. The multivariate logistic regression analysis indicated that estimated glomerular filtration rate, lactate levels, and systolic blood pressure were independently associated with 30-day mortality across all age categories. The presence of more than two major adverse events was independently associated with 30-day mortality specifically in the cohort aged ≥80 years (OR: 1.492, 95 % CI: 1.037–2.148, p = 0.031). Increasing age was identified as a significant factor associated with higher 30-day mortality rates in J-PVAD. While the incidence of major adverse events did not differ significantly across age categories, the occurrence of two or more additional adverse events was linked to increased 30-day mortality among older individuals. Therefore, an appropriate mechanical support strategy may be necessary for elderly Japanese patients based on their age. [Display omitted] •The association between Impella support and age has not been investigated.•Total of 5,282 patients treated with Impella were analyzed from J-PVAD.•The prognosis, was significantly poorer in ≥80 years old.•The e-GFR, lactate, and systolic blood pressure were associated with mortality across all age categories.•More than two major adverse events were associated with mortality in those aged ≥80.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39615836</pmid><doi>10.1016/j.jjcc.2024.11.007</doi><oa>free_for_read</oa></addata></record>
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subjects Acute decompensated heart failure
Hemodynamics
Liver function
Mortality
Plasma volume status
title Age-specific differences of Impella support in Japanese patients: The Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events
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