REVIVED

REVascularisation for Ischaemic VEntricular Dysfunction: a multi-centre prospective randomised control trial. NCT01920048;

[REVIVED @REVIVED_BCIS2]

3 years on, excellent summary of key insights by @divaka_perera

1️⃣ How much ischaemia/CAD was present/treated?

30% of LV (~5 segments) ischaemic

BCIS jeopardy score 10 (max possible=12)
Left main disease in 14%

85% of viable myocardium revascularised (if assigned to PCI)

[John Mandrola, MD @drjohnm]

No trial better explains the importance of evidence than REVIVED BCIS. It boggles my mind that it was negative

@divaka_perera is correct, but try telling 99% of American cardiologists

We still cath new LV dys pts TO FIND LESIONS TO REVASC despite negative trials #ESC2025

[Divaka Perera @divaka_perera]

Grateful for the skill and dedication of @UKheartresearch + @CTU_LSHTM teams, @CHIP_BCIS3 group and @BCIS_uk network for these important analyses. Looking forward to sharing new insights #TCT2026 in San Diego and #ScientificSessions26 in Chicago, very soon!

[Divaka Perera @divaka_perera]

BCIS Grand Rounds: ground-breaking research viewed through an inimitable @BCIS_uk lens!

It’s an honour to participate in the first one, when I will dive deep into (and zoom out from) @CHIP_BCIS3 with the distinguished panel and live audience 16 Sep ‘26 at 1730BST. Pre-register👇🏽

[Saad Ezad @SaadEzad]

🫀 NEW in @JACCJournals — @CHIP_BCIS3 hemodynamic substudy

Elective LV unloading in complex high-risk PCI:

❌ Did NOT prevent myocardial stunning
⚠️ More loss of pulse pressure → linked to myocardial injury
✅ Less vasoactive use

👇
https://t.co/zCFVlZrPuD

[BCIS @BCIS_uk]

Introducing BCIS Grand Rounds, a brand new webinar series bringing landmark clinical trials to life. Presented in a dynamic, podcast-style format with live audience Q&A.

🎙️CHIP – BCIS3
16 September | 17:30–18:30
Featuring @divaka_perera, Julian Gunn, Simon Ray, Jenny Rossington and Sohail Khan
👉Register: https://t.co/r4ax5CNs2d

#InterventionalCardiology #Cardiology #CHIPBCIS3 #OPTIMALLM #ClinicalTrials

[NEJM @NEJM]

CHIP-BCIS3 trial: Patients with severely impaired left ventricular function undergoing complex PCI are at high risk of death and complications. Elective unloading with a microaxial flow pump may improve outcomes. Research findings are summarized in a new Quick Take video. https://t.co/wrhnWIN6QH

[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)

[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

[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)

[BCIS-4 Trial @BCIS4Trial]

Our Co-CI @divaka_perera , recently presented CHIP-BCIS3 to international audience you can find it here: https://t.co/B5Prvm5c9n STICH-BCIS-4 is the next part of the research question surrounding ILVSD. The study is now 10 away from our 100th participant 🙌 #BCIS4 #ClinicalTrials

[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

[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]

Excited to share key studies at #ACC26 @ACCinTouch in New Orleans this weekend!

💥 @CHIP_BCIS3: RCT of Impella in high-risk PCI

📣 OCT-RISK: natural history of non-culprit plaque in STEMI

📢 ICDs in ICM: emulated RCT from @REVIVED_BCIS2

@Kings_BHFCentre @kingscardio @theBHF

[CHIP-BCIS3 @CHIP_BCIS3]

The countdown has begun … in just over 2 weeks, @divaka_perera will present the results of @CHIP_BCIS3 on behalf of the trial group @BCIS_uk at #ACC2026 @ACCinTouch!

The first RCT of elective unloading with a percutaneous LVAD v SOC in high-risk PCI. https://t.co/4r7vSkbBpT

[HeartRhythm @hrs_journal]

Ischemia modulation via coronary revascularization and effects on the arrhythmic substrate #OpenAccess

@hollymorgs @UKheartresearch

https://t.co/NVM1HueBs1

[Cardiac Research @UKheartresearch]

📢 We’re hiring: Research Project Manager funded by @TheBHF to coordinate the follow-up phase of the landmark @REVIVED_BCIS2 trial.

Opportunity to be involved in our other multicentre trials and wider research programme

🔗 Job details and application:
https://t.co/v1ntvMzlES

[Divaka Perera @divaka_perera]

@hollymorgs @drjohnm @BCIS_uk @REVIVED_BCIS2 @CHIP_BCIS3 @BCIS4Trial @kaulcsmc @REVIVED_BCIS2 (which excluded recent ACS and had few with limiting angina) and STICH were indication trials, with clear results.

@bcis4trial addresses modality in patients with a heart team-agreed indication for revasc. We didn’t feel it ethical to randomise them to OMT alone

[Divaka Perera @divaka_perera]

Building on the @BCIS_uk network, skills and knowledge built during BCIS-1, @REVIVED_BCIS2 and @CHIP_BCIS3, the @BCIS4Trial is well underway!

If you are part of the trial, or are keen to join, come to the investigator meeting #aci2026 to hear the latest developments!

[BCIS-4 Trial @BCIS4Trial]

If you’re heading to ACI 2026, join us for the BCIS‑4 Investigator Breakfast Briefing on 30 January, 07:15–08:15 at the Hilton Metropole.
Full details in the flyer.

@BCIS_uk, @MillbrookMed, @divaka_perera @DrPeterOKane #ACI2026 #BCIS4

[Cardiac Research @UKheartresearch]

Revascularization in severe LV dysfunction: State of Art paper just out in @JACCJournals @ACCinTouch https://t.co/8eGgL88mbj

CABG or PCI or OMT?
When to use MCS?
Does RHC help?
Pre-procedure planning
Ideal teams/skill sets
Major upcoming trials

https://t.co/HIUmujjxWX