Abstract
Background: Elective intra-aortic balloon pump (IABP) support may reduce acute complications occurring during percutaneous coronary interventions (PCI) in patients with severe depression of the left ventricular ejection fraction (EF ≤30%). Methods: Since February 1998, 133 consecutive patients with EF ≤30% underwent elective PCI in our institution; 61 had elective preprocedural IABP support (group A) and 72 patients had conventional PCI (group B). Jeopardy score was calculated in each patient from the coronary angiograms to quantify the myocardium at risk. Results: EF was similar in the 2 groups. Jeopardy score was higher in group A (8.0 ± 2.8 vs 6.7 ± 2.4, P = .008). The other principal clinical and angiographic characteristics were similar in the 2 groups. Severe hypotension and/or shock occurred in 11 patients, all in group B (P = .001). All required urgent IABP support, and 3 eventually died. Intraprocedural major adverse cardiac and cerebral events (eg, myocardial infarction, severe hypotension and/or shock, urgent bypass surgery, stroke, and death) were higher in group B (17% vs 0%, P = .001). By stepwise logistic regression analysis; elective IABP support (odds ration [OR] 0.11 [95% CI 0.21-0.60], P = .011), jeopardy score (OR 5.37 [95% CI 1.10-8.70], P = .040), and female sex (OR 2.72 [95% CI 1.85-3.10], P = .015), were the correlates of intraprocedural events. Conclusions: This study supports the potential usefulness of elective versus provisional IABP to prevent intraprocedural major adverse cardiac and cerebral events in high-risk PCI.
| Original language | English |
|---|---|
| Pages (from-to) | 700-707 |
| Number of pages | 8 |
| Journal | American Heart Journal |
| Volume | 145 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 1 2003 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Elective versus provisional intra-aortic balloon pumping in high-risk percutaneous transluminal coronary angioplasty. / Briguori, Carlo; Sarais, Cristiano; Pagnotta, Paolo; Airoldi, Flavio; Liistro, Francesco; Sgura, Fabio; Spanos, Vassilis; Carlino, Mauro; Montorfano, Matteo; Di Mario, Carlo; Colombo, Antonio.
In: American Heart Journal, Vol. 145, No. 4, 01.04.2003, p. 700-707.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Elective versus provisional intra-aortic balloon pumping in high-risk percutaneous transluminal coronary angioplasty
AU - Briguori, Carlo
AU - Sarais, Cristiano
AU - Pagnotta, Paolo
AU - Airoldi, Flavio
AU - Liistro, Francesco
AU - Sgura, Fabio
AU - Spanos, Vassilis
AU - Carlino, Mauro
AU - Montorfano, Matteo
AU - Di Mario, Carlo
AU - Colombo, Antonio
PY - 2003/4/1
Y1 - 2003/4/1
N2 - Background: Elective intra-aortic balloon pump (IABP) support may reduce acute complications occurring during percutaneous coronary interventions (PCI) in patients with severe depression of the left ventricular ejection fraction (EF ≤30%). Methods: Since February 1998, 133 consecutive patients with EF ≤30% underwent elective PCI in our institution; 61 had elective preprocedural IABP support (group A) and 72 patients had conventional PCI (group B). Jeopardy score was calculated in each patient from the coronary angiograms to quantify the myocardium at risk. Results: EF was similar in the 2 groups. Jeopardy score was higher in group A (8.0 ± 2.8 vs 6.7 ± 2.4, P = .008). The other principal clinical and angiographic characteristics were similar in the 2 groups. Severe hypotension and/or shock occurred in 11 patients, all in group B (P = .001). All required urgent IABP support, and 3 eventually died. Intraprocedural major adverse cardiac and cerebral events (eg, myocardial infarction, severe hypotension and/or shock, urgent bypass surgery, stroke, and death) were higher in group B (17% vs 0%, P = .001). By stepwise logistic regression analysis; elective IABP support (odds ration [OR] 0.11 [95% CI 0.21-0.60], P = .011), jeopardy score (OR 5.37 [95% CI 1.10-8.70], P = .040), and female sex (OR 2.72 [95% CI 1.85-3.10], P = .015), were the correlates of intraprocedural events. Conclusions: This study supports the potential usefulness of elective versus provisional IABP to prevent intraprocedural major adverse cardiac and cerebral events in high-risk PCI.
AB - Background: Elective intra-aortic balloon pump (IABP) support may reduce acute complications occurring during percutaneous coronary interventions (PCI) in patients with severe depression of the left ventricular ejection fraction (EF ≤30%). Methods: Since February 1998, 133 consecutive patients with EF ≤30% underwent elective PCI in our institution; 61 had elective preprocedural IABP support (group A) and 72 patients had conventional PCI (group B). Jeopardy score was calculated in each patient from the coronary angiograms to quantify the myocardium at risk. Results: EF was similar in the 2 groups. Jeopardy score was higher in group A (8.0 ± 2.8 vs 6.7 ± 2.4, P = .008). The other principal clinical and angiographic characteristics were similar in the 2 groups. Severe hypotension and/or shock occurred in 11 patients, all in group B (P = .001). All required urgent IABP support, and 3 eventually died. Intraprocedural major adverse cardiac and cerebral events (eg, myocardial infarction, severe hypotension and/or shock, urgent bypass surgery, stroke, and death) were higher in group B (17% vs 0%, P = .001). By stepwise logistic regression analysis; elective IABP support (odds ration [OR] 0.11 [95% CI 0.21-0.60], P = .011), jeopardy score (OR 5.37 [95% CI 1.10-8.70], P = .040), and female sex (OR 2.72 [95% CI 1.85-3.10], P = .015), were the correlates of intraprocedural events. Conclusions: This study supports the potential usefulness of elective versus provisional IABP to prevent intraprocedural major adverse cardiac and cerebral events in high-risk PCI.
UR - http://www.scopus.com/inward/record.url?scp=0037383603&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037383603&partnerID=8YFLogxK
U2 - 10.1067/mhj.2003.14
DO - 10.1067/mhj.2003.14
M3 - Article
C2 - 12679768
AN - SCOPUS:0037383603
VL - 145
SP - 700
EP - 707
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 4
ER -