Impact of Primary PCI With Pre-operative Intra-aortic Balloon Pump Implantation on Prognosis in Octogenarian Patients of Acute ST-segment Elevation Myocardial Infarction
10.3969/j.issn.1000-3614.2017.03.003
- VernacularTitle:直接经皮冠状动脉介入治疗前预防性置入主动脉内球囊反搏对大于80岁急性ST段抬高型心肌梗死患者的预后影响
- Author:
Pei ZHANG
;
Jun DAI
;
Yuan WU
;
Chaoyang ZHANG
;
Bo XU
;
Shijie YOU
;
Yongjian WU
;
Haibo LIU
;
Xuewen QIN
;
Hongbing YAN
;
Min YAO
;
Shubin QIAO
;
Yuejin YANG
;
Jilin CHEN
;
Runlin GAO
- Keywords:
Myocardial infarction;
Angioplasty;
transluminal;
percutaneous coronary;
Intra-aortic balloon pump counterpulsation
- From:
Chinese Circulation Journal
2017;32(3):217-221
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the impact of primary percutaneous coronary intervention (PPCI) with pre-operative intra-aortic balloon pump (P-IABP) implantation on short and long term prognosis in octogenarian patients of ST-segment elevation myocardial infarction (STEMI). Methods: We performed aretrospectively study in octogenarian STEMI patients treated in our hospital from 2004-01 to 2014-08. The patients were divided into 2 groups: P-IABP group,n=24 and PPCI group,n=73 including 12 patients who received rescue IABP (R-IABP) because of intra- or post-procedural hemodynamic collapse as a subgroup.Major end point events included 1 month and 1-, 2-year post-operative death; major adverse cardiac and cerebral events (MACCE) included 1 month post-operative cardiac shock, new or worsening heart failure (HF), re-infarction and stroke. The predictors causing different endpoint events were identiifed by Cox proportional hazard model analysis. Results: 1 month and 1-, 2-year post-operative death were similar between 2 groups (8.3% vs 16.4%), (16.7% vs 24.7%), (25.0% vs 30.1%) respectively; MACCE incidence was also similar (20.8% vs 30.1%), allP>0.05. Death rates between P-IABP group and R-IABP subgroup were similar at different time points,P>0.05; while MACCE incidence in P-IABP group was lower than R-IABP subgroup (20.8% vs 66.7%),P=0.005 and it was mainly presented by reduced HF occurrence (8.3% vs 41.7%),P=0.003. Coxproportional hazard model analysis indicated that post-operative TIMI lfow<3 grade was the independent predictor for 1 month death (HR=4.79, 95% CI1.59-14.39,P=0.005), complicating diseases as chronic obstructive pulmonary disease, kidney impairment and anemiawere themain independent predictors for 2-year death (HR=3.0, 95% CI 1.37-6.56,P=0.006). Conclusion: PPCI and P-IABP had no signiifcant differencefor short and long term survivalin octogenarianSTEMIpatients. Compared with R-IABP, P-IABP patients had the lower MACC Eincidence at 1 month post-operation .
