Peri-operative application of intra-aortic balloon pumping reduced in-hospital mortality of patients with coronary artery disease and left ventricular dysfunction

摘要

Background:There are few reports of peri-operative application of intra-aortic balloon pumping (IABP) in patients with coronary artery disease (CAD) and different grades of left ventricular dysfunction.This study aimed to analyze the early outcomes of perioperative application of IABP in coronary artery bypass grafting (CABG) among patients with CAD and left ventricular dysfunction,and to provide a clinical basis for the peri-operative use of IABP.Methods:A retrospective analysis of 612 patients who received CABG in the General Hospital of People's Liberation Army between May 1995 and June 2014.Patients were assigned to an IABP or non-IABP group according to their treatments.Logistic regression analysis was performed to investigate the influence of peri-operative IABP implantation on in-hospital mortality.Further subgroup analysis was performed on patients with severe (ejection fraction [EF] ≤ 35％) and mild (EF =36％-50％) left ventricular dysfunction.Results:Out of 612 included subjects,78 belonged to the IABP group (12.7％) and 534 to the non-IABP group.Pre-operative left ventricular EF (LVEF) and EuroSCOREII·predicted mortality was higher in the IABP group compared with the non-IABP group (P ＜ 0.001 in both cases),yet the two did not differ significantly in terms of post-operative in-hospital mortality (P =0.833).Regression analysis showed that IABP implantation,recent myocardial infarction,critical status,non-elective operation,and post-operative ventricular fibrillation were risk factors affecting in-hospital mortality (P ＜ 0.01 in all cases).Peri-operative IABP implantation was a protective factor against in-hospital mortality (P =0.0010).In both the severe and mild left ventricular dysfunction subgroups,peri-operative IABP implantation also exerted a protective role against mortality (P =0.0303 and P =0.0101,respectively).Conclusions:Peri-operative IABP implantation could reduce the in-hospital mortality and improve the surgical outcomes of patients with CAD with both severe and mild left ventricular dysfunction.