Kelly Julie, Malloy Rhynn, Knowles Danielle
Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis St Boston, Boston, MA, 02215, USA.
Thromb J. 2021 Jun 29;19(1):46. doi: 10.1186/s12959-021-00295-6.
There is limited guidance regarding the use of anticoagulation in patients on intra-aortic balloon pumps (IABP). The purpose of this study is to compare the safety outcomes in anticoagulated versus non-anticoagulated patients with an IABP.
This was a single center, retrospective chart review of patients admitted to the coronary care unit or cardiac surgery unit who received an IABP from May 2015 to July 2018. Patients who were anticoagulated with heparin while on an IABP were compared to those who were not anticoagulated. Major endpoints included a composite of thrombotic events and a composite of bleeding events. The major composite endpoint of thrombotic events included the incidence of ischemic stroke, any venous thromboembolism, device thrombosis, and limb ischemia. The major composite endpoint of bleeding events included major access site bleeding, minor access site bleeding, major non-access site bleeding, and minor non-access site bleeding. Minor endpoints included any major endpoint events occurring within 24 and 48 h of IABP insertion, hospital length of stay, intensive care unit length of stay, and in-hospital mortality.
A total of 185 patients were evaluated for inclusion and 147 were included in the final analysis. There were 82 and 65 patients in the heparin and non-heparin groups, respectively. The composite endpoint of thrombotic events occurred in 7.3 and 7.7% in the heparin and non-heparin groups, respectively (p = 1). The composite bleeding endpoint occurred in 20.7 and 20.0% in the heparin and non-heparin groups, respectively (p = 0.91). There were no differences found in minor endpoints between groups.
There were no significant differences found in major endpoints of bleeding and thrombotic events in patients who received anticoagulation while on an IABP versus those who did not receive anticoagulation.
关于在使用主动脉内球囊反搏（IABP）的患者中使用抗凝治疗的指导有限。本研究的目的是比较接受IABP治疗的抗凝患者与非抗凝患者的安全性结局。
这是一项单中心回顾性图表审查，研究对象为2015年5月至2018年7月入住冠心病监护病房或心脏外科病房并接受IABP治疗的患者。将在IABP治疗期间接受肝素抗凝的患者与未接受抗凝的患者进行比较。主要终点包括血栓形成事件的综合指标和出血事件的综合指标。血栓形成事件的主要综合终点包括缺血性卒中、任何静脉血栓栓塞、装置血栓形成和肢体缺血的发生率。出血事件的主要综合终点包括主要穿刺部位出血、次要穿刺部位出血、主要非穿刺部位出血和次要非穿刺部位出血。次要终点包括IABP置入后24小时和48小时内发生的任何主要终点事件、住院时间、重症监护病房住院时间和院内死亡率。
共有185例患者接受纳入评估，147例纳入最终分析。肝素组和非肝素组分别有82例和65例患者。肝素组和非肝素组血栓形成事件的综合终点发生率分别为7.3%和7.7%（p = 1）。肝素组和非肝素组出血综合终点发生率分别为20.7%和20.0%（p = 0.91）。两组次要终点无差异。
接受IABP治疗时接受抗凝的患者与未接受抗凝的患者相比，在出血和血栓形成事件的主要终点方面无显著差异。
