Key Laboratory of Ministry of Industry and Information Technology of Biomedical Engineering and Translational Medicine, Chinese PLA General Hospital, Beijing 100853, China.
Translational Medical Research Center, Chinese PLA General Hospital, Beijing 100853, China.
Biomed Res Int. 2021 Jan 20;2021:6656926. doi: 10.1155/2021/6656926. eCollection 2021.
Intra-aortic balloon counterpulsation is increasingly used in acute myocardial infarction complicated by cardiogenic shock. The aim of this study was to explore the preference, effect, and prognosis of intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock patients.
Data of acute myocardial infarction complicated by cardiogenic shock patients at the Fourth Medical Center of PLA General Hospital were collected retrospectively. A propensity score was calculated with a logistic regression which contained clinically meaningful variables and variables selected by Lasso and then used to match the control group. The cumulative incidence curve and Gray's test were employed to analyse the effect and prognosis of intra-aortic balloon counterpulsation on mortality.
A total of 1962 acute myocardial infarction cases admitted between May 2015 and November 2018 were identified, and 223 cases with acute myocardial infarction complicated by cardiogenic shock were included as the study cohort, which contained 34 cases that received IABP and 189 cases that did not receive IABP. Patients with higher alanine aminotransferase (OR = 1.93, 95% CI 1.29-2.98), higher triglyceride (OR = 3.71, 95% CI 1.87-7.95), and higher blood glucose (OR = 1.08, 95% CI 0.99-1.18) had a higher probability of receiving intra-aortic balloon counterpulsation. In the propensity score matching analysis, 34 cases received intra-aortic balloon counterpulsation and 102 matched controls were included in the comparison. By comparing the cumulative incidence of in-hospital mortality, there was no statistically significant difference between the intra-aortic balloon counterpulsation group and matched control group ( = 0.454).
The use of intra-aortic balloon counterpulsation may not improve the prognosis of the acute myocardial infarction complicated by cardiogenic shock patients.
主动脉内球囊反搏在急性心肌梗死合并心源性休克中越来越多地被使用。本研究旨在探讨主动脉内球囊反搏在急性心肌梗死合并心源性休克患者中的偏好、效果和预后。
回顾性收集解放军总医院第四医学中心急性心肌梗死合并心源性休克患者的数据。使用逻辑回归计算倾向评分,该评分包含有临床意义的变量和通过 Lasso 选择的变量,然后使用该评分匹配对照组。采用累积发生率曲线和 Gray 检验分析主动脉内球囊反搏对死亡率的影响和预后。
共纳入 2015 年 5 月至 2018 年 11 月期间收治的 1962 例急性心肌梗死患者,其中 223 例为急性心肌梗死合并心源性休克患者,包括 34 例接受 IABP 和 189 例未接受 IABP 的患者。丙氨酸氨基转移酶(OR=1.93,95%CI 1.29-2.98)、甘油三酯(OR=3.71,95%CI 1.87-7.95)和血糖(OR=1.08,95%CI 0.99-1.18)较高的患者接受主动脉内球囊反搏的可能性更高。在倾向评分匹配分析中,34 例接受主动脉内球囊反搏,102 例匹配对照,比较两组患者住院期间死亡率的累积发生率,差异无统计学意义(=0.454)。
主动脉内球囊反搏的使用并不能改善急性心肌梗死合并心源性休克患者的预后。