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<p>This multicenter study evaluated the prognostic impact of acute kidney injury (AKI) on one-year survival in patients undergoing Impella-supported high-risk percutaneous coronary intervention (hrPCI), and whether Impella use offers renal protection. A total of 470 patients from two independent cohorts were analyzed: the IMPELLA-PL group (n = 249, derivation cohort) and the Dresden group (n = 221, validation cohort). Patients with cardiogenic shock or chronic dialysis were not included. AKI—defined as a ≥ 0.5&#xa0;mg/dL increase in serum creatinine within 72&#xa0;h—occurred in 13.3% and 14.9% of patients, respectively, which was significantly lower than the predicted 26.1% risk based on the Mehran Risk Score. AKI was an independent predictor of one-year mortality in both the derivation (HR: 2.75; 95% CI: 1.11–6.82) and validation (HR: 2.16; 95% CI: 1.12–4.10) cohorts. Upfront Impella implantation and higher baseline glomerular filtration rate were independently associated with a reduced risk of AKI in both cohorts. The adverse effect of AKI on long-term survival was significant in males, but not in females. These findings indicate that although AKI remains a strong prognostic marker following hrPCI, early Impella support may mitigate this risk. The results also suggest potential sex-related differences in susceptibility to renal complications following complex coronary interventions.</p>

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Prognostic impact of acute kidney injury on one-year survival in patients undergoing high-risk PCI with Impella support

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月30日

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  • J. Sacha,
  • F. J. Woitek,
  • A. Pietrasik,
  • A. Laupp,
  • A. Gąsecka,
  • A. Conrad,
  • T. Pawłowski,
  • D. Obradovic,
  • M. Grygier,
  • S. Haussig,
  • G. Bielawski,
  • J. Mierke,
  • W. Balak,
  • S. Jellinghaus,
  • A. Sukiennik,
  • P. Burzyńska,
  • A. Witkowski,
  • M. Warniełło,
  • Ł. Rzeszutko,
  • S. Bartuś,
  • A. Pawlik,
  • M. Kaczyński,
  • R. Gil,
  • W. Kuliczkowski,
  • K. Reczuch,
  • M. Protasiewicz,
  • P. Kleczyński,
  • P. Wańczura,
  • S. Gurba,
  • A. Kochanowska,
  • M. Łomiak,
  • W. Skorupski,
  • M. Zarębiński,
  • P. Pawluczuk,
  • S. Włodarczak,
  • A. Włodarczak,
  • K. Ściborski,
  • A. Telichowski,
  • M. Pluciński,
  • J. Hiczkiewicz,
  • K. Konsek,
  • M. Hawranek,
  • M. Gąsior,
  • J. Peruga,
  • M. Fiutowski,
  • R. Romanek,
  • P. Kasprzyk,
  • D. Ciećwierz,
  • A. Ochała,
  • W. Wojakowski,
  • J. Legutko,
  • A. Linke,
  • J. Kochman,
  • N. Mangner

摘要

This multicenter study evaluated the prognostic impact of acute kidney injury (AKI) on one-year survival in patients undergoing Impella-supported high-risk percutaneous coronary intervention (hrPCI), and whether Impella use offers renal protection. A total of 470 patients from two independent cohorts were analyzed: the IMPELLA-PL group (n = 249, derivation cohort) and the Dresden group (n = 221, validation cohort). Patients with cardiogenic shock or chronic dialysis were not included. AKI—defined as a ≥ 0.5 mg/dL increase in serum creatinine within 72 h—occurred in 13.3% and 14.9% of patients, respectively, which was significantly lower than the predicted 26.1% risk based on the Mehran Risk Score. AKI was an independent predictor of one-year mortality in both the derivation (HR: 2.75; 95% CI: 1.11–6.82) and validation (HR: 2.16; 95% CI: 1.12–4.10) cohorts. Upfront Impella implantation and higher baseline glomerular filtration rate were independently associated with a reduced risk of AKI in both cohorts. The adverse effect of AKI on long-term survival was significant in males, but not in females. These findings indicate that although AKI remains a strong prognostic marker following hrPCI, early Impella support may mitigate this risk. The results also suggest potential sex-related differences in susceptibility to renal complications following complex coronary interventions.