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Real world data of acute coronary syndrome (ACS) patients who received intraaortic balloon pump (IABP) remains limited. Therefore, we evaluate the characteristics of ACS patients who received IABP support from a real world ACS registry.
Methods and Results
Patients with ACS (N=121) receiving IABP support were enrolled. Survivors and non survivors were compared at 30-days.
Mortality rate was 47%. The survivors (N=64) had a higher proportion of non-cardiogenic shock (CS) (p=<0.001), more IABP usage as back-up for a revascularization procedure (p=0.002), and fewer history of resuscitation (p=0.043) and mechanical ventilator support (p=<0.001). Compared to survivors, the non survivors had significantly higher leucocyte level (p=0.033), higher creatinine level (p<0.001), higher blood sugar on admission (p=0.001), higher serial CKMB level (p=0.002) and higher uric acid level (p<0.001), but significantly lower left and right ventricular function (p=0.014 and p=0.003, respectively). At 30 days, non-ST elevation (STE) ACS patients had higher cumulative survival than STEMI patients (log rank, p< 0.001) and non CS non STE-ACS patients showed the highest cumulative survival (p< 0.001).
By multivariable analysis, heart rate ≥100 x/minute prior to IABP insertion was the strongest predictor of 30-days mortality (Hazard Ratio 5.66; 95% CI 1.47 - 21.70; p= 0.011).
In ACS patients presenting with cardiogenic shock, resuscitated or need for mechanical ventilation, the short term mortality remains high, despite the use of IABP. IABP appears to be favourable in non cardiogenic shock ACS patients especially non STE-ACS. A heart rate of ≥ 100 x/minute prior to IABP insertion was the strongest predictor of 30-days mortality.
- 2013 American College of Cardiology Foundation