Vascular complications associated with intraaortic balloon pump supported percutaneous coronary intervention (PCI) and clinical outcomes from the British Cardiovascular Intervention Society National PCI Database.
Tim KinnairdRichard A AndersonSean GallagherAndrew S P SharpVasim FarooqPeter LudmanSamuel CoptNicholas CurzenAlex SirkerJim NolanMamas MamasPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2021)
Between 2007 and 2014, 9,970 PCIs in England and Wales were supported by IABP (1.6% of total PCI), with 224 femoral VCs (2.3%). Annualized rates of a VC reduced as the use of radial access for PCI increased. The independent predictors of a VC included a procedural complication (odds ratio [OR] 2.9, p < .001), female sex (OR 2.3, p < .001), PCI for stable angina (OR 3.47, p = .028), and use of a glycoprotein inhibitor (OR 1.46 [1.1:2.5], p = .04), with a lower likelihood of a VC when radial access was used for PCI (OR 0.48, p = .008). A VC was associated with a higher likelihood of transfusion (OR 5.7 [3.5:9.2], p < .0001), acute kidney injury (OR 2.6 [1.2:6.1], p = .027), and periprocedural MI (OR 3.2 [1.5:6.7], p = .002) but not with adjusted mortality at discharge (OR 1.2 [0.8:1.7], p = .394) or 12-months (OR 1.1 [0.76:1.56], p = .639). In sensitivity analyses, there was a trend towards higher mortality in patients experiencing a VC who underwent PCI for stable angina (OR 4.1 [1.0:16.4], p value for interaction .069). Discussion and Conclusions Although in-hospital morbidity was observed to be adversely affected by occurrence of a VC during IABP-supported PCI, in-hospital and 1-year survival were similar between groups.
Keyphrases
- percutaneous coronary intervention
- coronary artery disease
- st segment elevation myocardial infarction
- st elevation myocardial infarction
- antiplatelet therapy
- acute coronary syndrome
- acute myocardial infarction
- coronary artery bypass grafting
- cardiovascular events
- atrial fibrillation
- acute kidney injury
- coronary artery bypass
- healthcare
- cardiac surgery
- ejection fraction
- adverse drug
- type diabetes
- randomized controlled trial
- risk assessment
- emergency department
- heart failure
- end stage renal disease
- risk factors
- venous thromboembolism
- electronic health record
- newly diagnosed
- peritoneal dialysis
- patient reported outcomes
- direct oral anticoagulants
- prognostic factors
- left ventricular