Effect of gender on efficacy of preoperative intra-aortic balloon pump in high risk patients undergoing surgical coronary revascularisation
2010
Background: There is no strong evidence supporting the use of preoperative intra-aortic balloon pump (IABP) in high-risk
patients undergoing coronary artery bypass grafting (CABG). This issue has only been investigated in small studies which
analysed the general population of patients, without focusing on specific subgroups, including gender.
Aim: We sought to determine if there is any benefit from preoperative IABP in high-risk patients undergoing CABG with the
analysis of its determinants including gender.
Methods: We randomly assigned 502 high-risk patients (351 men, 151 women) to the group receiving preoperative IABP
support or to the control group with no preoperative IABP. Primary end-point was a major adverse cardiac or cerebrovascular
event (MACCE), defined as death from any cause, myocardial infarction, cerebrovascular accident or repeat revascularisation
within 30 days post-surgery.
Results: A significant reduction of MACCE rate in patients with the preoperative IABP counterpulsation in comparison to
controls was noticed in the total population of high risk patients (p = 0.001) and in the female subgroup (p = 0.005). After
adjustment for baseline characteristics, the hazard ratio for MACCE was 0.7 (p = 0.005) in the total population; 0.6 (p = 0.01)
for females and 0.8 (p = 0.1) for males.
Conclusions: There is a beneficial effect of preoperative IABP use in high-risk patients undergoing CABG, particularly in
women and patients with co-morbidities (diabetes, obesity, and peripheral vascular disease).
Kardiol Pol 2010; 68, 12: 1361-1368
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