Amin AP, Spertus JA, Curtis JP, et al. - In order to delineate the trends and disparities in Impella use, clinical outcomes and costs across US hospitals in percutaneous coronary intervention (PCI) patients treated with mechanical circulatory support (MCS) (Impella or intra-aortic balloon pump), researchers analyzed data of 48,306 patients undergoing PCI with MCS at 432 hospitals between January 2004-December 2016. Among PCI patients treated with MCS, Impella was used in 4,782 (9.9%) patients. A rapid increase of Impella use was observed over time, reaching 31.9% of MCS in 2016. Impella use varied widely across hospitals (> 5-fold variation). Although unmeasured confounding cannot be ruled out, higher rates of adverse events and costs were reported in correlation to Impella use when analyzed by time-periods, or at the hospital-level or the patient-level.