Clinical Factors Associated with In-Hospital Mortality in Patients with Acute Myocardial Infarction Who Required Intra-Aortic Balloon Pumping

Abstract

Recent guidelines do not recommend the routine use of intra-aortic balloon pumping (IABP) for patients with cardiogenic shock. However, IABP support is still selected for acute myocardial infarction (AMI) in clinical practice because an Impella device did not show superiority over IABP and the mortality of AMI with cardiogenic shock is still high. This study aimed to find factors associated with in-hospital mortality in patients with AMI who required IABP support. Overall, 104 patients with AMI who required IABP support were included as the study population. Of 104 patients, in-hospital death was observed in 19 (18.3%). Multivariate stepwise logistic regression analysis was performed to investigate the determinants of in-hospital death. Shock, resuscitation, estimated glomerular filtration rate (eGFR), pre-systolic blood pressure of IABP insertion, multivessel disease, fluoroscopy time, initial lactic acid dehydrogenase levels, and timing of IABP support were included as independent variables. Shock (OR 25.27, 95% CI 3.26-196.11, P = 0.002) was significantly associated with in-hospital death after controlling other covariates, whereas eGFR (every 10 mL/minute/1.73 m 2 increase: OR 0.65, 95% CI 0.51-0.82, P < 0.001) and pre-percutaneous coronary intervention (pre-PCI) insertion of IABP (versus on-PCI insertion of IABP: OR 0.06, 95% CI 0.008-0.485, P = 0.008) were inversely associated with in-hospital death. In conclusion, shock was significantly associated with in-hospital death, whereas eGFR and pre-PCI insertion of IABP were inversely associated with in-hospital death in patients with AMI who received IABP support. Pre-PCI insertion of an IABP catheter might be associated with better survival in AMI patients who potentially require IABP support.

Determinants of In-Hospital Death Among the Very Elderly with Acute Myocardial Infarction

“…Hypertension was defined as medical treatment for hypertension or a history of hypertension before admission. 9) Dyslipidemia was defined as medical treatment for dyslipidemia or a history of dyslipidemia. Diabetes mellitus was defined as a hemoglobin A1c level (as NGSP value) !6.5%, medical treatment for diabetes mellitus, or a history of diabetes mellitus.…”

Comparison of Outcomes of Elective Percutaneous Coronary Intervention between Complex and High-Risk Intervention in Indicated Patients (CHIP) versus Non-CHIP

“…Acute heart failure during PCI was defined as conditions that required the initiation of dobutamine or mechanical ventilator including noninvasive positive pressure ventilation during PCI. Hypertension was defined as systolic blood pressure ＞140 mmHg, diastolic blood pressure ＞90 mmHg, or medical treatment for hypertension 28) . Dyslipidemia was defined as a total cholesterol level ≥ 220 mg/dL, lowdensity lipoprotein cholesterol level ≥ 140 mg/dL, medical treatment for dyslipidemia, or a history of dyslipidemia 28) .…”

“…Hypertension was defined as systolic blood pressure ＞140 mmHg, diastolic blood pressure ＞90 mmHg, or medical treatment for hypertension 28) . Dyslipidemia was defined as a total cholesterol level ≥ 220 mg/dL, lowdensity lipoprotein cholesterol level ≥ 140 mg/dL, medical treatment for dyslipidemia, or a history of dyslipidemia 28) . Diabetes mellitus was defined as hemoglobin A1c ≥ 6.5% or treatment for diabetes mellitus 28) .…”

Determinants of Periprocedural Myocardial Infarction in Current Elective Percutaneous Coronary Interventions

“…20) Dyslipidemia was defined as a total cholesterol level "220 mg/dL or low-density lipoprotein cholesterol level "140 mg/dL or medical treatment for dyslipidemia or a history of dyslipidemia. 21) Diabetes mellitus was defined as a hemoglobin A1c level "6.5% (as NGSP value) or medical treatment for diabetes mellitus or a history of diabetes mellitus. 21) Chronic renal failure was defined as a creatinine level "2.0 mg/dL.…”

“…21) Diabetes mellitus was defined as a hemoglobin A1c level "6.5% (as NGSP value) or medical treatment for diabetes mellitus or a history of diabetes mellitus. 21) Chronic renal failure was defined as a creatinine level "2.0 mg/dL. 18) We also calculated the estimated glomerular filtration rate (eGFR) from the serum creatinine level, age, weight, and gender using the following formula: eGFR = 194 × Cr − 1.094 × age − 0.287 (male) and eGFR = 194 × Cr − 1.094 × age − 0.287 × 0.739 (female).…”