Incidence of 30-day Bleeding Events in Acute Coronary Syndrome Patients Treated With Intra-Aortic Balloon Pump

Background: Intra-Aortic Balloon Pump (IABP) has the potential to recover cardiogenic shock, blood flow to thecoronary arteries, or both; but bleeding events negatively affect the cardioprotective effects of IABP. Nonetheless,the real-world data in Japan regarding bleeding events after IABP implantation in patients with acute myocardialinfarction (AMI) remains insufficient.Methods: We investigated the incidence of major bleeding events in 249 AMI patients who underwent percutaneous coronary intervention (PCI) and IABP, with and without cardiogenic shock. In 97 (39%) patients, IABP wasused for cardiogenic shock, while 152 (61%) patients had IABP for other indications.Results: Patients with cardiogenic shock were significantly older and had a lower body weight, higher NT-proBNP and lactate levels, lower left ventricle ejection fraction (LVEF), and higher CREDO-Kyoto bleeding and PRECISE-DAPT scores than those without. During the follow-up period, 26 (10%) patients experienced a majorbleeding event, and 19 (8%) had major adverse cardiac events (MACE), but there were no significant differencesin those rates between those with and without cardiogenic shock. After multivariate analysis, anemia remained associated with a major bleeding event (adjusted odds ratio 2.40, 95% confidence interval 1.01–5.73, p = 0.047).Conclusions: Despite the low risk in patients who did not have cardiogenic shock, major bleeding events andMACE rates were similar to that of those with cardiogenic shock. Anemia was independently associated withmajor bleeding events in AMI patients who had IABP. The use of IABP should be carefully decided in AMI patients, especially in patients with noncardiogenic shock or anemia.