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IABP support associated with less mortality during PCI
Elective intra-aortic balloon pump support during PCI was associated with a 34% relative reduction in all-cause mortality compared with unsupported PCI, study results have shown.
In the Balloon-Pump Assisted Coronary Intervention Study (BCIS-1), 301 patients with left ventricular impairment, defined as ejection fraction <30%, and severe coronary disease, defined as BCIS1 Jeopardy Score ≥8 (maximum possible=12), were scheduled for PCI. Patients were enrolled from 17 centers in the United Kingdom between December 2005 and January 2009 and were randomly assigned to receive support with elective intra-aortic balloon pump (IABP; n=151) or no IABP support (n=150). Long-term all-cause mortality was assessed from national databases.
The groups had balanced baseline characteristics with average LV ejection fraction of 23.6% and BCIS-1 Jeopardy score of 10.4. The amount and type of revascularization performed were comparable, and mortality data were available for the entire cohort at a median of 51 months.
During follow-up, all-cause mortality was 100 deaths (33%) in the overall cohort, with 42 patients dying in the elective IABP group and 58 patients in the group without planned IABP (HR=0.66; 95% CI, 0.44-0.98). Mortality rates per 100 patient-years were 7.9% in the IABP group and 12.1% in the group not receiving IABP support.
“It is interesting to note that the HR at 6 months of follow-up is essentially similar to the HR at long-term follow-up, which would be consistent with an early treatment effect, that is subsequently maintained,” researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.