Korean J Med.  2015 Aug;89(2):186-191. 10.3904/kjm.2015.89.2.186.

Outcome of Percutaneous Coronary Intervention with Intra-Aortic Balloon Pump in Patients with Cardiogenic Shock

• Lee JP
• Nam CW
• Park JH
• Bae JY
• Kim IC
• Cho YK
• Park HS
• Yoon HJ
• Kim H
• Hur SH
• Kim YN
• Kim KB

• KMID: 2269027
• DOI: http://doi.org/10.3904/kjm.2015.89.2.186

Abstract

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.

Keyword

Acute coronary syndrome; Shock, Cardiogenic; Percutaneous coronary intervention; Intra-aortic balloon pumping

MeSH Terms

Acute Coronary Syndrome
Aging
Arrhythmias, Cardiac
Cardiopulmonary Resuscitation
Creatine Kinase
Hospital Mortality
Hospitalization
Humans
Incidence
Intra-Aortic Balloon Pumping
Mortality
Myocardial Infarction
Percutaneous Coronary Intervention*
Respiration, Artificial
Self-Help Devices
Shock, Cardiogenic*
Survivors
Ventilators, Mechanical
Creatine Kinase