Clinical therapeutic efficacy of intra-aortic balloon pump as an adjuvant treatment after percutaneous coronary intervention in patients with coronary heart disease associated with chronic kidney disease / 解放军医学杂志

ABSTRACT

Objective To explore the clinical efficacy of intra-aortic balloon pump (IABP) as an auxiliary treatment of percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD) associated with chronic kidney disease. Methods One hundred and twenty CHD patients with concomitant chronic kidney disease and receiving PCI in our hospital from Jan. 2000 to Jul. 2014, and 123 simple CHD patients without renal dysfunction, who had undergone PCI with concomitant IABP for the cardiac pump failure, cardiogenic shock, acute left heart failure, unstable angina pectoris (UP) which was not allayed by medical treatment, or acute myocardial infarction (AMI), were selected for observation of preoperative condition, in-hospital mortality and prognosis of patients in two groups. Results There was no statistically significant difference in general clinical data including gender, age, and concomitant hypertension and diabetes, and preoperative blood lipid, AST, D-dimer, APTT, and international normalized ratio (INR) showed also no statistically significant difference before surgery between two groups of patients (P>0.05). The difference in proportion of AMI, the left main trunk and (or) three-branches involvement was of no statistical significance (P>0.05), but there was significant difference in the incidence of previous myocardial infarction, TnT, CK-MB, Cr, BUN, stent number, IABP application time (P0.05) between the two groups. Logistic regression analysis revealed that diabetes and the number of stents were independent risk factors for in-hospital and long-term mortalities. Conclusions By means of the effective cardiac assistance of IABP, CHD patients with renal insufficiency have the same short and long term clinical prognosis as simple CHD patients without renal dysfunction who has undergone PCI. Diabetes and the number of stents are independent risk factors for in-hospital and 1-year mortality.