Severely depressed LVEF was independently associated with major vascular complications in AMI patients receiving intra-aortic balloon pump support (OR 2.57; 95% CI 1.8-5.62; p=0.018).
Cohort (n=694)
No
In patients with AMI receiving IABP support, major vascular complications occur in 4.8% of cases and are independently predicted by severely depressed LVEF.
Odds Ratio: 2.57 (95% CI 1.8–5.62)
p-value: p=0.018
Abstract Background Intra-aortic balloon pump (IABP) is a valuable intervention for managing acute myocardial infarction (AMI) in carefully selected patients. However, its broader application is hindered by a significant risk of vascular complications. To enhance patient selection and reduce adverse events, a comprehensive understanding of the clinical predictors of major vascular complications is essential, yet remains limited. Purpose We aimed to assess the incidence of vascular complications and to identify predictors of major vascular complications (MVC) in patients with AMI implanted with IABP in a tertiary center. Methods We conducted a retrospective single-center cohort study. Patients with AMI who received IABP support between 1 january 2005 and 31 may 2023 were included. Patients with missing data on vascular complications were excluded. Demographic data, comorbidities, clinical characteristics, vascular complications, and outcomes were assessed. The sample was divided into two groups based on the presence (group B) or absence (group A) of MVC. Statistical analyses, including multivariable logistic regression, were used to compare the groups, and identify independent predictors of MVC. Results A total of 694 patients were included (73.2% male, mean age 67±12 years, mean BMI 27±4 kg/m2). There was a high prevalence of cardiovascular risk factors and heart failure (Table 1). The main indications for IABP implantation were cardiogenic shock (40.6%) and hemodynamic support until CABG (27.4%). Most patients had severely reduced left ventricle ejection fraction (LVEF; 27.7%). The overall rate of MVC rate was 4.8% (n=33), including cases of lower limb ischemia (2.2%), 11 of major hemorrhage (1.6%), 8 vascular lesions requiring vascular surgery (1.2%), and 2 of intra-arterial balloon rupture (0.3%). Minor vascular complications occurred in 7.5% (n=52), with 43 local hematomas (6.2%) and 9 minor hemorrhages (1.3%). Group B had a higher proportion of severely depressed LVEF (45.5 vs 26.8%, p=0.019) and a trend toward lower creatinine clearance (51 ± 26 vs 61 ± 29 mL/min, p=0.193), and greater vasopressor use (73.3 vs. 65.4%, p=0.111). In-hospital mortality was higher in group B (45.5% vs. 23.3%, p=0.004). No differences in-hospital stay or duration of IABP support were observed between the groups. Multivariate analysis showed that severely depressed EF (OR 2.57; CI 1.8-5.62, p=0.018) and in-hospital mortality (OR 2.23; CI 1.01-4.88, p=0.036) were independently associated with MVC (Table 2). Conclusions Major vascular complications were infrequent in AMI patients with IABP support but linked to higher in-hospital mortality. Severely depressed LVEF and in-hospital mortality were independently associated with the complications. These findings underscore the importance of careful patient selection for IABP therapy.
Quintal et al. (2025) conducted a cohort in Acute myocardial infarction (AMI) (n=694). Severely depressed LVEF vs. Non-severely depressed LVEF was evaluated on Major vascular complications (MVC) (OR 2.57, 95% CI 1.8-5.62, p=0.018). Severely depressed LVEF was independently associated with major vascular complications in AMI patients receiving intra-aortic balloon pump support (OR 2.57; 95% CI 1.8-5.62; p=0.018).