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Benefits of Intraaortic Balloon Support for Myocardial Infarction Patients in Severe Cardiogenic Shock Undergoing Coronary Revascularization.
- Source :
-
PloS one [PLoS One] 2016 Aug 02; Vol. 11 (8), pp. e0160070. Date of Electronic Publication: 2016 Aug 02 (Print Publication: 2016). - Publication Year :
- 2016
-
Abstract
- Background: Prior studies have suggested intraaortic balloon pump (IABP) have a neutral effect on acute myocardial infarction (AMI) patients with cardiogenic shock (CS). However, the effects of IABP on patients with severe CS remain unclear. We therefore investigated the benefits of IABP in AMI patients with severe CS undergoing coronary revascularization.<br />Methods and Results: This study identified 14,088 adult patients with AMI and severe CS undergoing coronary revascularization from Taiwan's National Health Insurance Research Database between January 1, 1997 and December 31, 2011, dividing them into the IABP group (n = 7044) and the Nonusers group (n = 7044) after propensity score matching to equalize confounding variables. The primary outcomes included myocardial infarction(MI), cerebrovascular accidents or cardiovascular death. In-hospital events including dialysis, stroke, pneumonia and sepsis were secondary outcomes. Primary outcomes were worse in the IABP group than in the Nonusers group in 1 month (Hazard ratio (HR) = 1.97, 95% confidence interval (CI) = 1.84-2.12). The MI rate was higher in the IABP group (HR = 1.44, 95% CI = 1.16-1.79), and the cardiovascular death was much higher in the IABP group (HR = 2.07, 95% CI = 1.92-2.23). The IABP users had lower incidence of dialysis (8.5% and 9.5%, P = 0.04), stroke (2.6% and 3.8%, P<0.001), pneumonia (13.9% and 16.5%, P<0.001) and sepsis (13.2% and 16%, P<0.001) during hospitalization than Nonusers.<br />Conclusion: The use of IABP in patients with myocardial infarction and severe cardiogenic shock undergoing coronary revascularization did not improve the outcomes of recurrent myocardial infarction and cardiovascular death. However, it did reduce the incidence of dialysis, stroke, pneumonia and sepsis during hospitalization.
- Subjects :
- Aged
Cohort Studies
Databases, Factual
Female
Humans
Male
Middle Aged
Myocardial Infarction complications
Myocardial Infarction mortality
Myocardial Infarction pathology
Percutaneous Coronary Intervention
Pneumonia etiology
Pneumonia mortality
Pneumonia pathology
Renal Dialysis mortality
Sepsis etiology
Sepsis mortality
Sepsis pathology
Shock, Cardiogenic complications
Shock, Cardiogenic mortality
Shock, Cardiogenic pathology
Stroke etiology
Stroke mortality
Stroke pathology
Survival Analysis
Taiwan
Treatment Outcome
Intra-Aortic Balloon Pumping
Myocardial Infarction therapy
Pneumonia therapy
Sepsis therapy
Shock, Cardiogenic therapy
Stroke therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 11
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 27483439
- Full Text :
- https://doi.org/10.1371/journal.pone.0160070