Key result
Immediate intra-aortic balloon pumping for suspected acute complications during CABG resulted in similar in-hospital mortality compared to uncomplicated controls (6.7% vs 0%, P=0.492).
Why the study?
Does immediate perioperative IABP improve hospital and mid-term prognosis in low-risk CABG patients who develop acute complications?
Case-Control (n=60)
Does immediate perioperative IABP improve hospital and mid-term prognosis in low-risk CABG patients who develop acute complications?
Absolute Event Rate: 6.67% vs 0%
p-value: p=0.492
Early use of IABP in low-risk CABG patients with suspected perioperative complications is associated with mid-term survival and complication rates comparable to those of uncomplicated CABG patients.
May support early IABP in complicated low-risk CABG; hypothesis-generating, requires RCTs before practice change.
We evaluated the impact of immediate intra-aortic balloon pumping (IABP) on hospital and mid-term outcome of coronary artery bypass graft (CABG) whenever perioperative acute complications developed. We compared clinical, biochemical, echocardiographic in-hospital results and two-year follow-up outcome of 30 low-risk (EuroSCORE<5) CABG (group A) who immediately received perioperative IABP when acute complications were suspected, to a contemporary, uncomplicated case-matched group (30 patients; Group B). Two in-hospital deaths were recorded in group A with no deaths in controls (P=0.492). Group A showed significantly higher lactate only at ICU arrival (P=0.001). Troponin I was always higher, but never reached values diagnostic for myocardial infarction (P<0.001). Worse left ventricular ejection fraction (P<0.001) and wall motion score index (P=0.008) were recorded at ICU arrival in group A, although an almost complete recovery was registered at discharge. Two-year actuarial survival was similar between the two groups (P=0.598). No differences were observed in freedom from acute myocardial infarction (P=0.503) and from overall cardiac complications (P=0.410). Early IABP should be established whenever cardiac complications are suspected, because of its beneficial impact on enzymatic leakage, myocardial recovery at echocardiography, hospital outcome, mid-term follow-up survival and freedom from cardiovascular events.
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Rubino et al. (2008) conducted a case-control in CABG with suspected perioperative acute complications (n=60). Immediate intra-aortic balloon pumping (IABP) vs. Contemporary, uncomplicated case-matched group was evaluated on In-hospital deaths (p=0.492). Immediate intra-aortic balloon pumping for suspected acute complications during CABG resulted in similar in-hospital mortality compared to uncomplicated controls (6.7% vs 0%, P=0.492).
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