Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry
- 1 January 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Cardiovascular Quality and Outcomes
- Vol. 5 (1), 21-30
- https://doi.org/10.1161/circoutcomes.110.960385
Abstract
Background—: Intra-aortic balloon pumps (IABP) frequently are used to provide hemodynamic support during high risk percutaneous coronary intervention (PCI), but clinical evidence to support their use is mixed. We examined hospital variation in IABP use among high risk PCI patients, and determined the association of IABP use on mortality in this population. Methods and Results—: We analyzed data submitted to the CathPCI Registry between January 2005 and December 2007. High risk PCI was defined as having at least 1 of the following features: unprotected left main artery as the target vessel, cardiogenic shock, severely depressed left ventricular function, or ST segment elevation myocardial infarction. Hospitals were categorized into quartiles by their proportional use of IABP. We examined differences in in-hospital mortality across hospital quartiles using a hierarchical logistic regression model to adjust for differences in patient and hospital characteristics across hospital quartiles of IABP use. IABPs were used in 18 990 (10.5%) of 181 599 high risk PCIs. Proportional use of IABP varied significantly across hospital quartiles: Q1, 0.0 to 6.5%; Q2, 6.6 to 9.2%; Q3, 9.3 to 14.1%; Q4, 14.2 to 40.0%. In multivariable analysis, after adjustment for differences in patient and hospital characteristics, in-hospital mortality was comparable across quartiles of hospital IABP usage (Q1, Ref; Q2, odds ratio 1.11, 95% CI 0.99–1.24; Q3, OR 1.03, 95% CI 0.92–1.15; Q4, OR 1.06, 95% CI 0.94–1.18). Conclusions—: IABP use varied significantly across hospitals for high risk PCI. However, this variation in IABP use was not associated with differences in in-hospital mortality.Keywords
This publication has 25 references indexed in Scilit:
- Elective versus provisional intraaortic balloon pumping in unprotected left main stentingAmerican Heart Journal, 2006
- Role of Prophylactic Intra-Aortic Balloon Pump in High-Risk Patients Undergoing Percutaneous Coronary InterventionThe American Journal of Cardiology, 2006
- Appropriate Assessment of Neighborhood Effects on Individual Health: Integrating Random and Fixed Effects in Multilevel Logistic RegressionAmerican Journal of Epidemiology, 2005
- Relation Between Hospital Intra-Aortic Balloon Counterpulsation Volume and Mortality in Acute Myocardial Infarction Complicated by Cardiogenic ShockCirculation, 2003
- Elective versus provisional intra-aortic balloon pumping in high-risk percutaneous transluminal coronary angioplastyAmerican Heart Journal, 2003
- A randomized comparison of intra-aortic balloon pumping after primary coronary angioplasty in high risk patients with acute myocardial infarctionPublished by Oxford University Press (OUP) ,1999
- Role of intraaortic balloon pump counterpulsation in high risk coronary rotational atherectomyJournal of the American College of Cardiology, 1995
- High-risk coronary angioplasty with elective intra-aortic balloon pump supportInternational Journal of Cardiology, 1992
- Supported “high risk” coronary angioplasty using intraaortic balloon pump counterpulsationJournal of the American College of Cardiology, 1990
- “High‐risk” percutaneous transluminal coronary angioplasty with preventive intra‐aortic balloon counterpulsationCatheterization and Cardiovascular Diagnosis, 1990