- 作者：Giedrius Davidavicius ; MD?/sup> ; &dagger ; ; Cosmo Godino ; MD?/sup> ; &Dagger ; ; Joanne Shannon ; MD?/sup> ; &Dagger ; ; Kensuke Takagi ; MD?/sup> ; &Dagger ; ; Letizia Bertoldi?/sup> ; Marco Mussardo ; MD?/sup> ; Alaide Chieffo ; MD?/sup> ; Francesco Arioli ; MD?/sup> ; Alfonso Ielasi ; MD?/sup> ; Mateo Montorfano ; MD?/sup> ; Azeem Latib ; MD?/sup> ; &Dagger ; ; Antonio Colombo ; MD?/sup> ; &Dagger ; ; info@emocolumbus.it
- 关键词：bleeding ; cardiogenic shock ; IABP ; mortality
- 刊名：JACC: Cardiovascular Interventions
- 出版年：2012
- 出版时间：March, 2012
- 年：2012
- 卷：5
- 期：3
- 页码：350-357
- 全文大小：891 K
Objectives
This study aims to report a ¡°real-world?experience of in hospital complications and clinical outcome of a large cohort of consecutive patients who underwent percutaneous coronary intervention (PCI) with intra-aortic balloon pump counterpulsation (IABP) support, from a tertiary care center over a 12-year period.Background
The incidence of vascular complications in patients treated with PCI and IABP is expected to be higher due to simultaneous puncture of femoral arteries, larger IABP sheath size, and longer duration of IABP therapy.
Methods
A total of 360 consecutive patients (mean age of 65.9 ¡À 11.2 years; 80.6 % male) who required an IABP support during percutaneous PCI were classified into 3 groups: Urgent: 133 patients (36.9 % ) admitted with acute coronary syndrome in whom IABP therapy was started before urgent PCI; Emergent: 56 patients (15.6 % ) in whom emergent IABP insertion was required to manage hypotension during PCI; and Elective: 171 patients (47.5 % ) with stable angina pectoris in whom IABP was inserted before elective PCI. Overall bleeding was defined according to the newest the Bleeding Academic Research Consortium (BARC) definition criteria.
Results
BARC bleeding occurred in 68 patients (19 % ), with the highest incidence noted in the Urgent group (31.1 % ), in comparison with the Emergent (26.8 % ) and Elective (7 % ) groups, p < 0.0001. Bleeding related to the IABP access site was 7.5 % , which accounted for 82 % of any access site-related bleeding. It was significantly higher in the Urgent group (12.8 % ) compared with the Elective (4.1 % ) and Emergent (5.4 % ) groups. At multivariate analysis, IABP treatment duration and renal impairment were the only independent predictors of BARC bleeding.
Conclusions
Bleeding related to the IABP access site was significantly higher in the Urgent group and accounted for more than two-thirds of overall access site-related bleeding. IABP treatment duration and renal impairment were independent predictors of overall bleeding.