TY - JOUR
T1 - Incidence of overall bleeding in patients treated with intra-aortic balloon pump during percutaneous coronary intervention
T2 - 12-year Milan experience
AU - Davidavicius, Giedrius
AU - Godino, Cosmo
AU - Shannon, Joanne
AU - Takagi, Kensuke
AU - Bertoldi, Letizia
AU - Mussardo, Marco
AU - Chieffo, Alaide
AU - Arioli, Francesco
AU - Ielasi, Alfonso
AU - Montorfano, Mateo
AU - Latib, Azeem
AU - Colombo, Antonio
PY - 2012/3
Y1 - 2012/3
N2 - 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 ± 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 siterelated 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 siterelated bleeding. IABP treatment duration and renal impairment were independent predictors of overall bleeding.
AB - 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 ± 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 siterelated 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 siterelated bleeding. IABP treatment duration and renal impairment were independent predictors of overall bleeding.
KW - IABP
KW - bleeding
KW - cardiogenic shock
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=84858775426&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858775426&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2011.12.012
DO - 10.1016/j.jcin.2011.12.012
M3 - Article
C2 - 22440503
AN - SCOPUS:84858775426
SN - 1936-8798
VL - 5
SP - 350
EP - 357
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 3
ER -