Publications by authors named "Julia B Thompson"
Background: Transcatheter aortic valve replacement (TAVR) is an accepted alternative to surgery in many patients with severe aortic stenosis. Clinical trials have evaluated early and late outcomes in selected TAVR patients, but predictors of late mortality have been less well studied in a broadly inclusive, national patient cohort undergoing TAVR. We sought to characterize 5-year outcomes after TAVR in Medicare beneficiaries and to evaluate the incremental predictive value of demographics, comorbidities, procedural factors, frailty, and social vulnerability in determining late mortality risk.
View Article and Find Full Text PDFNovel risk score for patients undergoing Impella-assisted high-risk percutaneous coronary intervention.
Cardiovasc Revasc Med
May 2025
Background: High-risk percutaneous coronary intervention (HRPCI) procedures supported by percutaneous left ventricular assist devices (pLVAD) are increasingly common, but existing PCI risk scores were developed in patients across the risk spectrum, including few pLVAD-assisted patients.
Objectives: Assess the performance of existing PCI risk scores in patients receiving pLVAD-assisted HRPCI and create a novel risk score specific to this group.
Methods: Patients in the PROTECT III multicenter, observational (46 US centers) study undergoing pLVAD-assisted HRPCI were assessed.
Background: Coronary bifurcation lesions (CBL) are associated with lower procedural success, worse postprocedural outcomes, and greater unplanned repeat revascularization. We sought to better understand the impact of Impella support in patients undergoing percutaneous coronary intervention (PCI) of CBLs.
Methods: We used data from the cVAD PROTECT III study (NCT04136392), an FDA-audited, single-arm study of patients undergoing high-risk PCI with Impella support, to examine the outcomes of patients undergoing PCI of CBLs.
Article Synopsis
- * Among 239 patients assessed, 124 had RVD, which was linked to factors like lower left ventricular ejection fraction and higher blood urea nitrogen levels, but did not significantly affect certain immediate procedural outcomes.
- * RVD was found to be a strong predictor of worse long-term outcomes, with higher rates of major adverse cardiac and cerebrovascular events (MACCE) at 90 days and increased mortality at one year post-procedure.
Association of Preprocedural SYNTAX Score With Outcomes in Impella-Assisted High-Risk Percutaneous Coronary Intervention.
J Soc Cardiovasc Angiogr Interv
August 2024
Background: Patients with complex coronary artery disease, as defined by high SYNTAX scores, undergoing percutaneous coronary intervention (PCI) have poorer outcomes when compared with patients with lower SYNTAX I scores. This study aimed to assess if mechanical circulatory support using Impella mitigates the effect of the SYNTAX I score on outcomes after high-risk percutaneous coronary intervention (HRPCI).
Methods: Using data from the PROTECT III study, patients undergoing Impella-assisted HRPCI between March 2017 and March 2020 were divided into 3 cohorts based on SYNTAX I score-low (≤22), intermediate (23-32), and high (≥33).
Article Synopsis
- Anemia is common among patients with cardiovascular disease, particularly those undergoing high-risk percutaneous coronary intervention (HRPCI) with Impella support, and is linked to worse outcomes.
- The study evaluated patients' hemoglobin levels to categorize them into no anemia, mild anemia, and moderate/severe anemia, revealing that anemic patients tended to be older and had more health issues.
- Results showed that anemia significantly increased rates of major adverse cardiovascular events and major bleeding at 30 and 90 days, highlighting the need for focused strategies to manage anemia's impact on patient outcomes after HRPCI.
Background: There are limited data on the clinical characteristics and outcomes of patients who require prolonged mechanical circulatory support (MCS) after Impella-supported high-risk percutaneous coronary intervention (HR-PCI).
Aims: The aim of this study is to describe the contemporary clinical characteristics, outcomes, and predictors associated with prolonged MCS support after assisted HR-PCI.
Methods: Patients enrolled in the prospective, multicentre, clinical endpoint-adjudicated PROTECT III study who had undergone HR-PCI using Impella were evaluated.
Background: Pathologic response at the time of surgery after neoadjuvant therapy for HER2 positive early breast cancer impacts both prognosis and subsequent adjuvant therapy. Comprehensive descriptions of the tumor microenvironment (TME) in patients with HER2 positive early breast cancer is not well described. We utilized standard stromal pathologist-assessed tumor infiltrating lymphocyte (TIL) quantification, quantitative multiplex immunofluorescence, and RNA-based gene pathway signatures to assess pretreatment TME characteristics associated pathologic complete response in patients with hormone receptor positive, HER2 positive early breast cancer treated in the neoadjuvant setting.
View Article and Find Full Text PDF