Objective To evaluate the therapeutic effect and safety, and the result of coronary angiography (CAG) and serum brain natriuretic peptide (BNP) level in patients with acute coronary syndrome complicated with pump failure treated with intra aortic balloon pump (IABP).
Methods Between January 2008 and May 2009, 121 patients with acute coronary syndrome (ACS) and pump failure were divided into IABP group (61 cases) and the control group (60cases), respectively. There were 76 male patients and 45 female patients, while 77 were ST-elevation myocardial infarction (STEMI), 35 were Non ST-elevation myocardial infarction (NSTEMI) and 9 were Unstable angina pectoris (UA).40 patients fell into Killip rank-II, 45 patients fell into [i]Killip rank-III, while 36 patients fell into Killip rank-IV. All of them were suitable for IABP treatment and there was no contraindication. They all received basical treatment, including anti-anginal therapy, anti-platelet, cholesterol lowing, eatl. All patients underwent CAG and percutaneous coronary intervention (PCI). The IABP group were treated with IABP while the control group were not. Evaluations 1. Clinical effect (including the effect of angina and pump failure), timing in hospital, death rate in 30d 2. The CAG result after PCI. 3. The level of EF measured by cadioultrasound. 4. The level of BNP were measured.
Results After treatment, the IABP group were higher significantly than the control group in clinical effect, including the effect of angina and pump failure [94.7% vs 71.6% (p 0.05)]; IABP group was lower than the control group on the BNP after treatment, there were significantly difference in two groups (4893±966→316±91 vs 4687±912→511±120 (ng/l) (p<0.01). As for the complication, there were few patients with bleeding (3.2% (2/61)), haematoma (3.2%(2/61)), acute earterial embolism (1.6% (1/61)), fever (1.6% (1/61)), platelet decreasing (4.8% (3/61)). Although there were more complications in IABP group, after treatment the symptom got advanced and there were no severe complication.
Conclusion IABP can significantly advance the haemodynamic indexes and serum BNP level of the patients of ACS with pump failure, can ease the pain of Angina, improve the tolerance and successful rate of the PCI treatment, and decrease death rate. And there is no severe complication, and it is a kind of safe treatment.