The Hong Kong Registry for Percutaneous Ventricular Assist Device

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: High-risk percutaneous coronary intervention, cardiogenic shock, and decompensated heart failure (n=962). Intervention: Percutaneous ventricular assist device (Impella 2.5, Impella CP, Impella RP). Primary outcome: 30-day mortality in cardiogenic shock patients (95% CI 32.9%-42.8%).

Jonathan Gabriel Sung; K. H. So; Frankie Chor-Cheung Tam; Calvin Leung; John Cheong-Hin Chan; Candy Ming-Yan Cheuk; Joyce Shek; K. Shek; Ricky Wang-Hei Leung; Ho Tin Pong; Karl Chan; Man Chi Fong; Katie Wing-Sum Fan; Johnathan Ho-Cheung Wong; Esmond Yan Hang Fong; Cheuk-hon John Wong; Raymond Chi-yan Fung; Tak-Shun Chung; Chi Wing Wong; Lap Tin Lam; Daniel Ho-Fai Fong; Sze-Wah Lai; Ho Ling Tsoi; Kin Lam Tsui; Ka Lung Chui; Li Wah Tam; Michael Kang-Yin Lee

doi:10.1016/j.jacasi.2026.02.025

Key result

Percutaneous ventricular assist device implantation for cardiogenic shock in Hong Kong was associated with a 30-day mortality rate of 37.8%.

Why the study?

With the emergence of percutaneous ventricular assist devices altering the management of complex CAD, cardiogenic shock, and heart failure, the HK-PVAD Registry was established to evaluate the safety, efficacy, and trends of PVAD use across the Hong Kong public health care system.

Key Points

Evaluate the safety, efficacy, and utilization trends of percutaneous ventricular assist devices across public healthcare centers for high-risk coronary interventions, cardiogenic shock, and decompensated heart failure.
Analyzed an all-comers territory-wide registry of consecutive patients (N=962) receiving percutaneous ventricular assist devices from January 1, 2018, to December 31, 2024.
Covered 14 centers, including all 7 tertiary centers representing approximately 94% (124 of 132) of local public cardiac care unit beds, utilizing Impella devices (predominantly 2.5 and CP).
Assessed indication trends and 30-day outcomes through electronic chart review stored in a centralized database.
Percutaneous device use for high-risk percutaneous coronary intervention plateaued over 3 to 4 years, followed by a surge in cardiogenic shock cases from 5 in 2018 to 129 in 2023.
Among patients with cardiogenic shock, the 30-day mortality rate was 37.8% (140 of 370; 95% CI: 32.9%-42.8%).
The overall 30-day survival rate for patients treated for cardiogenic shock was 62.2% (230 of 370; 95% CI: 57.2%-67.1%).

Study Design

Type

Cohort (n=962)

Multicenter

Yes

Structured PICO

P

Population

962 consecutive patients undergoing percutaneous ventricular assist device (Impella) implantation for high-risk PCI, cardiogenic shock, or decompensated heart failure across 14 public centers in Hong Kong between 2018 and 2024.

E

Exposure

Percutaneous ventricular assist device (PVAD) implantation using Impella devices (predominantly Impella 2.5 and Impella CP, as well as Impella RP).

O

Outcome

30-day mortality (and 30-day survival) in patients receiving PVAD for cardiogenic shock, and temporal trends in PVAD case volume from 2018 to 2024.hard clinical

Limitations

Retrospective registry study design with follow-up performed by chart review
Devices are only government-reimbursed for surgical turndown in high-risk PCI or patients under age 70 in cardiogenic shock, otherwise requiring self-financing
Retrospective observational study design relying on electronic health record chart review
Potential selection bias due to reimbursement criteria (government reimbursement limited to surgical turndowns in high-risk PCI and patients below age 70 in cardiogenic shock; otherwise self-financed)

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Implication

This territory-wide registry establishes the first all-comers real-world benchmark in Asia for Impella use across high-risk PCI, cardiogenic shock, and decompensated heart failure, demonstrating a 62.2% 30-day survival rate in cardiogenic shock.

Abstract

ith advances in devices and techniques of percutaneous coronary intervention (PCI) and mechanical circulatory support (MCS), cardiologists are managing patients with high-risk coronary artery disease (CAD), cardiogenic shock, and heart failure of increasing complexity.The emergence of novel percutaneous ventricular assist devices (PVADs) such as Impella has completely altered the landscape of managing these challenging clinical conditions.The Catheter-Based Ventricular Assist Devices (cVAD) Registry, preceded by the USpella Registry before 2016, 1 is an ongoing prospective international database that assesses the use of Impella to support high-risk PCI, cardiogenic shock, and decompensated heart failure. 2 In Asia, the Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) is a nationwide registry enrolling consecutive cardiogenic shock patients who were treated with Impella. 3 It registered all patients with drugrefractory acute heart failure including cardiogenic shock with attempted or successful implantation of Impella.Hong Kong has a population of over 7.5 million, and almost all patients with acute myocardial infarction (AMI) attend the public health care system.According to local census, 34,238 admissions were related to CAD in 2023.4 The total number of mortality due to CAD was 4,110, accounting for 7.2% of all registered deaths.The HK-PVAD Registry has been established to encompass all patients who underwent PVAD implantation within the public health care system in Hong Kong since 2018.It has enrolled consecutive patients receiving PVAD for all 3 major indications: high-risk PCI, cardiogenic shock, and decompensated heart failure.

Discussion

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Cite This Study

Sung et al. (2026) conducted a cohort in High-risk percutaneous coronary intervention, cardiogenic shock, and decompensated heart failure (n=962). Percutaneous ventricular assist device (Impella 2.5, Impella CP, Impella RP) was evaluated on 30-day mortality in cardiogenic shock patients (95% CI 32.9%-42.8%). Percutaneous ventricular assist device implantation for cardiogenic shock in Hong Kong was associated with a 30-day mortality rate of 37.8%.

synapsesocial.com/papers/6aeb084c8b8e50026669d1c5 https://doi.org/10.1016/j.jacasi.2026.02.025

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The Hong Kong Registry for Percutaneous Ventricular Assist Device

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The Hong Kong Registry for Percutaneous Ventricular Assist Device

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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