Evolução hospitalar de pacientes submetidos a assistência circulatória com balão intra-aórtico durante intervenção coronária percutânea de alto risco: registro InCor

ABSTRACT In-Hospital Outcomes of Patients Submitted toCirculatory Support with Intra-Aortic BalloonPump During High Risk Percutaneous CoronaryIntervention: InCor Registry Background: The intra-aortic balloon pump (IABP) has beenused for decades as a circulatory support device, beingrecommended in most guidelines, despite poor evidence ofmortality reduction. The purpose of this study was to evaluatethe use of IABP as an adjunct therapy in percutaneouscoronary intervention (PCI). Methods: Single center registryanalyzing in-hospital outcomes of 134 consecutive patientssubmitted to IABP during high risk PCI or in the presenceof cardiogenic shock. Results: Mean age was 64.7 + 12.5years and 67.9% were males. The population presentedhigh-risk features, with 33.5% of diabetic patients, 73.1%treated in the presence of myocardial infarction, 68.6%with three-vessel disease and left ventricular ejection fractionof 38.6 + 16.1%. TIMI 2/3 flow was obtained in 86.4% ofthe cases and 1.6 + 0.6 lesion/patient was treated. Therewere 18 (13.4%) reinfarctions, of which 9 (6.7%) were dueto stent thrombosis, 2 (1.4%) patients were referred forCABG and 16 (11.9%) for a new PCI. Hospital mortalitywas 61.2% and the major adverse cardiac events (MACE)rate was 67.2%. By multivariate analysis, predictors ofmortality were: age > 65 years, prior PCI, need of dialysisand three-vessel disease. Predictors of survival were: normalventricular function, TIMI 2/3 flow at the end of the procedureand IABP utilization > 72 hours.