Factors Affecting Mortality in Patients Treated with Intra-Aortic Balloon Counter Pulsation Due to Cardiogenic Shock Post CABG
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- Category: Vol. 77, March 2009
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Factors Affecting Mortality in Patients Treated with Intra-Aortic Balloon Counter Pulsation Due to Cardiogenic Shock Post CABG,TAREK A. NOSSEIR and MAGED SALAH
Abstract
Background and Aim: During many years of intra-aortic balloon counter pulsation (IABP) application in the treatment of myocardial infarction (MI) more and more indications for this treatment have been proposed. Despite increasing expe-rience with IABP, the clinical effects of IABP use are still unclear, especially when applied in cardiogenic shock. Inci-dence of cardiogenic shock has remained high, complicating 7 to 10 per cent of acute MI (1). The aim of this study was to determine results of IABP use and factors which affect mortality in cardiogenic shock (CS) post CABG.
Methods: 30 patients (mean age 58.3±12.6 years, 22 males) undergoing IABP were included in the study. Data were collected and mortality rates were assessed.
Results: In-hospital death occurred in 12 patients. Over half of these patients (n=7; 58.3%) died during first 7 days from insertion of IABP. The reason for IABP introduction was CS post CABG in all patients. The mortality in patients complicated by CS was 40%. The features which significantly influenced mortality in these patients were age-patients who died were older (64±7.8 Vs. 58.6±8.2; p=0.03) and ST segment changes-there was lower mortality rate in a subgroup with ST elevation AMI (8 Vs. 4 patients, p=0.003). We also observed slightly higher incidence of anterior wall AMI in survivors than in non-survivors (p=0.06).
Conclusion: Our study presents CS post CABG treated with IABP. In this study, survivors and non-survivors differed mainly in age, ST segment changes and infarction site. Non ST segment elevation AMI was associated with worse prog-nosis.