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KMID : 0882420150890020186
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Korean Journal of Medicine
2015 Volume.89 No. 2 p.186 ~ p.191
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Outcome of Percutaneous Coronary Intervention with Intra-Aortic Balloon Pump in Patients with Cardiogenic Shock
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Lee Jae-Pil
Nam Chang-Wook
Park Jung-Ho
Bae Jong-Yop
Kim In-Cheol
Cho Yun-Kyeong
Park Hyoung-Seob
Yoon Hyuck-Jun
Kim Hyung-Seop
Hur Seung-Ho
Kim Yoon-Nyun
Kim Kwon-Bae
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Abstract
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Background/Aims: The mortality of hospitalized patients undergoing treatment with an intra-aortic balloon pump (IABP) due to cardiogenic shock is well known as quite high. The aim of this study was to evaluate the outcome of percutaneous coronary intervention (PCI) with an IABP in patients with acute coronary syndrome (ACS) and cardiogenic shock and identify the predictors of in-hospital mortality.
Methods: 134 patients who underwent PCI with IABP due to ACS complicated by cardiogenic shock were consecutively enrolled. Outcomes were obtained and analyzed during hospitalization and after 1 year.
Results: The incidence of all-cause mortality was 35.8% (in-hospital mortality, 34.3%; 1-year mortality, 1.5%). The nonsurvival group exhibited higher peak levels of creatine kinase MB; lower ejection fractions; and higher incidences of ST elevation myocardial infarction, ventricular arrhythmia, and use of an assistive device than did the survival group. Aging (hazard ratio 2.839; 95% confidence interval 1.408-5.723; p = 0.004), the use of a temporary pacemaker (2.035; 1.114-3.720; 0.021), the use of a mechanical ventilator (4.376; 1.852-10.341; 0.001), and the performance of cardiopulmonary resuscitation (CPR) (2.219; 1.017-4.839; 0.045) were independent predictors for in-hospital mortality. However, out-of-hospital mortality among in-hospital survivors was not affected by predictors of in-hospital mortality.
Conclusions: The incidence of in-hospital mortality was high, as expected in patients undergoing PCI with IABP due to ACS with cardiogenic shock. Aging, CPR, and additional procedures such as pacemaker use and mechanical ventilation were predictors of in-hospital mortality. However, the patients who were successfully discharged after the complex procedure showed acceptable 1-year outcomes.
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KEYWORD
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Acute coronary syndrome, Shock, Cardiogenic, Percutaneous coronary intervention, Intra-aortic balloon pumping
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