Elective IABP Insertion May Not Improve Post-PCI Outcome

Similar rate of major events found in patients who do, do not receive intra-aortic balloon pump

TUESDAY, Aug. 24 (HealthDay News) -- Elective intra-aortic balloon pump (IABP) insertion does not appear to improve outcomes after high-risk percutaneous coronary intervention (PCI), according to a study in the Aug. 25 issue of the Journal of the American Medical Association.

Divaka Perera, M.D., of King's College London, and colleagues studied outcomes in patients with severe left ventricular dysfunction and extensive coronary disease who underwent PCI, 151 of whom received elective IABP and 150 of whom did not, to determine whether routine IABP insertion reduces major adverse cardiac and cardiovascular events (MACCE) in these patients.

The researchers found MACCE at hospital discharge in 23 (15.2 percent) of elective IABP recipients and 24 (16 percent) of those who did not receive IABP (P = .85). At six months, all-cause mortality was 4.6 and 7.4 percent in the two groups, respectively (P = .32). The IABP recipients experienced fewer major procedural complications than the other group (1.3 versus 10.7 percent; P < .001).

"Elective IABP insertion did not reduce the incidence of MACCE following PCI. These results do not support a strategy of routine IABP placement before PCI in all patients with severe left ventricular dysfunction and extensive coronary disease," the authors write.

The trial was sponsored by the British Cardiovascular Intervention Society, which received funds from Maquet Cardiovascular, Johnson & Johnson, and Cordis. Lilly provided abciximab for the trial.

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