Intra-Aortic Balloon Pump: Overall and Temporal Trends of Comparative Effectiveness in a National Registry

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2024-12-24 DOI:10.1002/ccd.31372

Ben Cohen, Eran Kalmanovich, Leor Perl, Gabi Greenberg, Roy Beigel, Tal Ovdat, Ran Kornowski, Katia Orvin

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引用次数: 0

Abstract

Background

Although the latest studies failed to prove the benefit of routine intra-aortic balloon pump (IABP) use in patients with acute myocardial infarction (MI) presenting with cardiogenic shock, the benefit of IABP utilization in selected cases in “real world” practice is unknown.

Aims

We sought to follow temporal trends in IABP use in a real-world cohort of acute coronary syndrome (ACS).

Methods

We evaluated IABP utilization and patient outcomes from the Acute Coronary Syndrome in Israel Survey (ACSIS) between the years 2000 and 2021. Temporal trends and outcomes with IABP at two time periods were set: early (before 2012) and late (after 2012).

Results

Out of 18,662 ACS patients, 3.7% received IABP. The rate of IABP use was 4.5% in the early period and decreased to ~2.5% in the late period (p < 0.001). Patients treated with IABP in the early period had more frequently reduced ejection fraction (64.5% vs. 53.2%, p < 0.01) and presented mostly with ST-elevation MI (71.0% vs. 62.4%, p = 0.04). Cardiogenic shock on admission and in-hospital occurred equally in both periods (14.6% vs. 17.1%, p = 0.66; 42.8% vs. 41.9%, p = 0.90, respectively). Thirty-day mortality and MACE were comparable between time periods (28% vs. 30.7%, p = 0.547; 43.6% vs. 44.1%, p = 0.978, respectively) however bleeding complications were significantly higher in the later period (4.8% vs. 11.2%, p = 0.04).

Conclusions

Our real-world ACS data demonstrated a 50% reduction in the utilization of IABP among acute MI patients in the last decade. A comparable poor prognosis with IABP across time periods, suggest sustainable worse outcome in routine albeit selective clinical practice.

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主动脉内球囊泵：在国家登记中比较有效性的总体和时间趋势。

背景：尽管最新的研究未能证明常规主动脉内球囊泵（IABP）在急性心肌梗死（MI）并发心源性休克患者中的益处，但在“现实世界”实践中，IABP在选定病例中的益处尚不清楚。目的：我们试图追踪现实世界急性冠脉综合征（ACS）队列中IABP使用的时间趋势。方法：我们评估了2000年至2021年间以色列急性冠脉综合征调查（ACSIS）中IABP的使用情况和患者结局。IABP在两个时间段的时间趋势和结果：早期（2012年之前）和晚期（2012年之后）。结果：18662例ACS患者中，3.7%接受了IABP治疗。IABP的使用率在早期为4.5%，在晚期降至~2.5% (p)。结论：我们的真实ACS数据显示，在过去十年中，急性心肌梗死患者IABP的使用率降低了50%。IABP在不同时期的预后相当差，表明常规临床实践（尽管是选择性的）可持续性更差的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.