CHIP-BCIS3

UK investigator-led multicentre prospective RCT on efficacy & safety of LV unloading in high-risk PCI. Funded by @NIHRresearch; @kingscardio @CTU_LSHTM @bcis_uk

[CHIP-BCIS3 @CHIP_BCIS3]

The @NIHRresearch-funded @CHIP_BCIS3 trial published in @NEJM https://t.co/kFOd0JLqt1

👎🏽 elective insertion of an Impella CP device did not reduce major adverse outcomes in high-risk PCI

☢️ more cardiovascular deaths and myocardial injury in Impella group than standard care

[Cardiac Research @UKheartresearch]

Late Breaking #EuroPCR2026: @CHIP_BCIS3 hemodynamic sub study to be presented on Thursday 21st May by @SaadEzad (funded by @TheBHF)

❓Does elective mAFP (Impella) prevent hemodynamic instability and reduce stunning

❓Do RHC metrics predict outcomes/identify mAFP responders

[CHIP-BCIS3 @CHIP_BCIS3]

@NEJM Trial results, editorial and quick take video summary published in @NEJM today! https://t.co/kFOd0JLqt1

Fantastic achievement for @BCIS_uk- a result that provides clarity and will help to improve the outcomes of these high-risk patients.

@kingscardio @NIHRresearch @CTU_LSHTM

[Sunil V. Rao @SVRaoMD]

@realarainmd @hollymorgs @UKheartresearch @CHIP_BCIS3 The mortality rate was higher in the mAFP arm. The PPMI doesn’t matter as much

[Divaka Perera @divaka_perera]

We included ppMI in the composite primary outcome as our hypothesis was that mAFP use would protect the myocardium from injury. But it turned out myocardial injury was MORE likely with mAFP.

ppMI was only used to determine wins in pairs tied on MACE… and favoured standard care

[Divaka Perera @divaka_perera]

The pre-specified hierarchy of components in the primary outcome ensured mortality “trumped” other MACE, which trumped ppMI.

Mortality was higher with mAFP and had the greatest impact on the Win Ratio (40% of pair-wise comparisons decided by death … and favoured standard care)

[Cardiac Research @UKheartresearch]

P Vranckx, J Møller, G Tavazzi say routine use of elective MCS cannot be supported on the basis of @CHIP_BCIS3 but note modest sample size. https://t.co/auhCNWrtOI

But isn’t it events that determine power? 221 of 300 pts experienced a composite primary outcome! (129 excl. ppMI)

[PCRonline 🫀 @PCRonline]

🤝 3 multidisciplinary PCR Focus Groups are advancing cardiovascular care ⭐ Mechanical circulatory support ⭐ Mitral valve disease ⭐ Tricuspid valve disease 🎥 Prof. F. Maisano explains how → https://t.co/u2lVlY47EW
#interventionalcardiology #cardiology

[NEJM @NEJM]

Original Article: Left Ventricular Unloading in High-Risk Percutaneous Coronary Intervention (CHIP-BCIS3 trial) https://t.co/r35dEK3zYL

Editorial: Price of Protection — Microaxial Flow Pump in High-Risk PCI https://t.co/fcll43CVxw

#ACC26 | @ACCinTouch

[NEJM @NEJM]

Presented at #ACC26:

Among patients undergoing complex PCI, elective unloading with a microaxial flow pump did not reduce the risk of major adverse clinical outcomes as compared with standard care. Full CHIP-BCIS3 trial results: https://t.co/4Hgqf7PvZz

Editorial: Price of Protection — Microaxial Flow Pump in High-Risk PCI https://t.co/AjunvmGyOO

@ACCinTouch

[CHIP-BCIS3 @CHIP_BCIS3]

📣 the pre-specified hemodynamic (RHC) sub-study of @chip_bcis3 will be presented as a late breaker at #EuroPCR2026 @PCRonline by @SaadEzad

@divaka_perera discusses the rationale with @aayshacader 👇🏽 and a deep dive into Win Ratio + other design features of the this trial

[PCRonline 🫀 @PCRonline]

🔥#ACC26 Late-breaking trials 🔥: CHIP-BCIS3

🔗https://t.co/vq24x2tK1b

@aayshacader interviews 🎤@divaka_perera about the results of this randomised trial, which evaluated whether elective left ventricular (LV) unloading during high-risk PCI improves outcomes in patients with severe LV dysfunction, extensive coronary disease, and complex procedures.

#interventionalcardiology #CHIP #cardioX #clinicalresearch

[Cardiac Research @UKheartresearch]

@mirvatalasnag @CHIP_BCIS3 On the contrary, the treatment effect (lack of benefit of mAFP) was remarkably consistent across the pre-specified subgroups in @CHIP_BCIS3

https://t.co/di6FqTdP3W

[CHIP-BCIS3 @CHIP_BCIS3]

Watch this QandA session between @radcliffeCARDIO and @divaka_perera to learn more about why the CHIP-BCIS3 trialists used the win ratio analysis of a hierarchical composite, practical take home messages for interventional cardiologists and the likely impact on clinical practice

[Radcliffe Cardiology @radcliffeCARDIO]

💥 #ACC26 Exclusive: Prof @divaka_perera joins us to discuss CHIP‑BCIS3 - a trial exploring percutaneous left ventricular unloading in patients undergoing high‑risk coronary intervention.

Could mechanical support before and during PCI transform outcomes in this fragile population? A must‑watch for interventionalists and heart‑failure teams.

🎥Watch the full discussion here: https://t.co/hwRSWHe7lI

#CardioX #Cardiology #InterventionalCardiology #CHIPBCIS3 #LVUnloading #HighRiskPCI #ACC26 #ClinicalTrials #HeartFailure

[CHIP-BCIS3 @CHIP_BCIS3]

Ajay Kirtane, @mmamas1973 and @divaka_perera discuss @CHIP_BCIS3 during #acc26 @ACCinTouch … what constitutes high risk-PCI, how will the trial results change practice, what lessons can we learn from the trial beyond MCS? … and more

https://t.co/VT1ODpOuuu

[CHIP-BCIS3 @CHIP_BCIS3]

This remarkable project would not have been possible if not for the dedication and sacrifices made by many.

The investigators are indebted to the 300 patients who selflessly volunteered and to those who worked tirelessly behind the scenes.

🙏🏽

[CHIP-BCIS3 @CHIP_BCIS3]

The @NIHRresearch-funded @CHIP_BCIS3 trial published in @NEJM https://t.co/kFOd0JLqt1

👎🏽 elective insertion of an Impella CP device did not reduce major adverse outcomes in high-risk PCI

☢️ more cardiovascular deaths and myocardial injury in Impella group than standard care

[Cardiac Research @UKheartresearch]

If you are at #ACC26 @ACCinTouch and want to know more about @CHIP_BCIS3 … come to Meet the Trialists in Meet Up Zone 1 at 1200 CDT on Monday 30 @divaka_perera @DrPeterOKane @robmentz

https://t.co/di6FqTdP3W

[Holly @hollymorgs]

https://t.co/ZsOU6Cg1Zs @drjohnm @DavidLBrownMD @thiele_holger @DrAsifQasim @purviparwani

[Holly @hollymorgs]

🚨 CHIP-BCIS3 randomised 300 patients with LVEF ≤35% undergoing high risk PCI to either micro axial flow pump or standard care

➡️ mAFP did not reduce major adverse clinical outcomes
⚠️ There was an excess of CV death in patients who received PCI with mAFP

#ACC26 @BCIS_uk

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

#ACC26 LBCT: @CHIP_BCIS3 up front Impella in high risk PCI doesn't improve outcomes - hear from Chief Investigator @divaka_perera

Find expert analysis and an audio summary at https://t.co/CmBZJuCCIc - share your thoughts on how this trial changes practice

@hollymorgs @DrMattRyan @BCIS_uk @KingsCollegeLon @KingsCollegeNHS @GSTTnhs @TheBHF @Kings_BHFCentre @mmamas1973 @aayshacader @mirvatalasnag @TYoungstein @cpgale3 @ShrillaB

[heba wassif @DrHebaMD]

@DrAsifQasim @aayshacader @CHIP_BCIS3 @divaka_perera @hollymorgs Excellent presentation and that is when evidence guides enthusiasm . His thanks to all the patients that participated was gracious and compassionate