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在一家三级诊所的重症心脏监护病房中插入主动脉内球囊反搏的急性冠状动脉综合征患者的临床特征及预后

Clinical characteristics and outcomes of acute coronary syndrome patients with intra-aortic balloon pump inserted in intensive cardiac care unit of a tertiary clinic.

作者信息

Hayıroğlu Mert İlker, Çanga Yiğit, Yıldırımtürk Özlem, Bozbeyoğlu Emrah, Gümüşdağ Ayça, Uzun Ahmet Okan, Kalenderoğlu Koray, Keskin Muhammed, Çinier Göksel, Acarel Murat, Pehlivanoğlu Seçkin

机构信息

Department of Cardiology, Haydapaşa Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2018 Jan;46(1):10-17. doi: 10.5543/tkda.2017.11126.

DOI:10.5543/tkda.2017.11126
PMID:29339686
Abstract

OBJECTIVE

An intra-aortic balloon pump (IABP) is a mechanical support device that is used in addition to pharmacological treatment of the failing heart in intensive cardiac care unit (ICCU) patients. In the literature, there are limited data regarding the clinical characteristics and in-hospital outcomes of acute coronary syndrome patients in Turkey who had an IABP inserted during their ICCU stay. This study is an analysis of the clinical characteristics and outcomes of these acute coronary syndrome patients.

METHODS

The data of patients who were admitted to the ICCU between September 2014 and March 2017 were analyzed retrospectively. The data were retrieved from the ICCU electronic database of the clinic. A total of 142 patients treated with IABP were evaluated in the study. All of the patients were in cardiogenic shock following percutaneous coronary intervention, at the time of IABP insertion.

RESULTS

The mean age of the patients was 63.0±9.7 years and 66.2% were male. In-hospital mortality rate of the study population was 54.9%. The patients were divided into 2 groups, consisting of survivors and non-survivors of their hospitalization period. Multivariate analysis after adjustment for the parameters in univariate analysis revealed that ejection fraction, Thrombolysis in Myocardial Infarction flow score of ≤2 after the intervention, chronic renal failure, and serum lactate and glucose levels were independent predictors of in-hospital mortality.

CONCLUSION

The mortality rate remains high despite IABP support in patients with acute coronary syndrome. Patients who are identified as having a greater risk of mortality according to admission parameters should be further treated with other mechanical circulatory support devices.

摘要

目的

主动脉内球囊反搏泵(IABP)是一种机械支持装置,用于重症心脏监护病房(ICCU)中对心力衰竭患者进行药物治疗之外的辅助治疗。在文献中,关于土耳其急性冠状动脉综合征患者在ICCU住院期间植入IABP的临床特征和院内结局的数据有限。本研究旨在分析这些急性冠状动脉综合征患者的临床特征和结局。

方法

回顾性分析2014年9月至2017年3月期间入住ICCU的患者数据。数据从该科室的ICCU电子数据库中获取。本研究共评估了142例接受IABP治疗的患者。所有患者在植入IABP时均处于经皮冠状动脉介入术后的心源性休克状态。

结果

患者的平均年龄为63.0±9.7岁,男性占66.2%。研究人群的院内死亡率为54.9%。将患者分为两组,即住院期间的存活者和非存活者。在对单因素分析中的参数进行调整后的多因素分析显示,射血分数、干预后心肌梗死溶栓血流评分≤2、慢性肾功能衰竭以及血清乳酸和葡萄糖水平是院内死亡的独立预测因素。

结论

尽管急性冠状动脉综合征患者接受了IABP支持,但其死亡率仍然很高。根据入院参数被确定为死亡风险较高的患者应进一步使用其他机械循环支持装置进行治疗。

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