Objective To evaluate the efficacy and security of percutaneous coronary intervention (PCI) supported by intra-aortic balloon pump (IABP) for patients with high risk coronary heart disease.
Methods We retrospectively reviewed immediate success rate of PCI, in-hospital survival rate and complications of 624 patients with high risk coronary heart disease who underwent PCI supported by IABP in our institution from January 2000 to October 2011.
Results Out of all the 624 patients, 71% were ST-elevation myocardial infarction (STEMI), 21% were none ST-elevation myocardial infarction (NSTEMI) and 8% were unstable angina pectoris (UAP). The patients (averagely aged 68 years and 71% were males) suffered from hypertension (78%), family history of coronary heart disease (34%), abnormal metabolism of serum lipids (69%) and diabetes (45%). The latter two seemed presenting more frequently in patients with acute myocardial infarction (AMI). The incidence of major adverse cardiovascular events (MACE) in STEMI and NSTEMI group was significantly higher than that in UAP group (3.1% and 2.9% vs. 0.01%, P < 0.01). So was the mortality rate (1.7% and 1.1% vs. 0.4%, P < 0.01). Before hospital discharge, a majority of patients received antiplatelet therapy and evidence based drug therapy, including angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blockers (ARBs), beta-blockers, calcium channel blockers and statins. With the support of IABP, immediate success of PCI was achieved in 323 cases with an immediate success rate up to 97.6% (609/624); in-hospital survival in 576 cases with a survival rate up to 92.3% (576/624); IABP success rate was 100%; total incidence of IABP complications needed to be handled was 4.5% (28/624).
Conclusions The success rate of PCI for patients with high risk coronary heart disease is extremely high when IABP support was applied, with an ideal prognosis and decreased complications. This method is clinically safe and efficient with high feasibility. The advantages become more evident when treating patients with AMI complicated by high risk of cardiogenic shock.