The IC CHAT episode 17 —Is the MFP necessary for all HR-PCI cases? CHIP-BCIS answers this very question

Host Dr. Ashish Pershad introduces IC Chat’s mission to help clinicians interpret evidence-based medicine and translate trial data into everyday patient care. In this episode he appraises the CHIP-BCIS-3 randomized trial (ACC 2026 / NEJM) comparing prophylactic microaxial flow pump (Impella) versus standard care in very high‑risk elective PCI patients. The trial enrolled patients with low LVEF and high SYNTAX/BCIS scores and used a hierarchical win‑ratio primary endpoint. Results showed no overall benefit for Impella and a concerning signal of increased cardiovascular mortality at two years in the device group, despite similar completeness of revascularization and low bleeding/vascular complication rates. Dr. Pershad discusses implications: avoid routine prophylactic Impella in elective high‑risk PCI, consider staged revascularization, and call for reappraisal of device use and approval processes to prioritize patient safety.