Elective versus provisional intra-aortic balloon pumping in high-risk percutaneous transluminal coronary angioplasty

Carlo Briguori, Cristiano Sarais, Paolo Pagnotta, Flavio Airoldi, Francesco Liistro, Fabio Sgura, Vassilis Spanos, Mauro Carlino, Matteo Montorfano, Carlo Di Mario, Antonio Colombo

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)700-707
Number of pages8
JournalAmerican Heart Journal
Volume145
Issue number4
DOIs
Publication statusPublished - Apr 1 2003

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Intra-Aortic Balloon Pumping
Coronary Balloon Angioplasty
Percutaneous Coronary Intervention
Hypotension
Shock
Self-Help Groups
Stroke Volume
Myocardium
Angiography
Logistic Models
Stroke
Myocardial Infarction
Regression Analysis

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 journalArticle

Briguori, Carlo ; Sarais, Cristiano ; Pagnotta, Paolo ; Airoldi, Flavio ; Liistro, Francesco ; Sgura, Fabio ; Spanos, Vassilis ; Carlino, Mauro ; Montorfano, Matteo ; Di Mario, Carlo ; Colombo, Antonio. / Elective versus provisional intra-aortic balloon pumping in high-risk percutaneous transluminal coronary angioplasty. In: American Heart Journal. 2003 ; Vol. 145, No. 4. pp. 700-707.
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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.",
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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.

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