Factors affecting mortality in patients treated with intra-aortic balloon counter pulsation due to cardiogenic shock post CABG

ABSTRACT

During many years of intra-aortic balloon counter pulsation [IABP] application in the treatment of myocardial infarction [MI] more and more indications for this treatment have been proposed. Despite increasing experience with IABP, the clinical effects of IABP use are still unclear, especially when applied in cardiogenic shock. Incidence of cardiogenic shock has remained high, complicating 7 to 10 per cent of acute MI [I]. The aim of this study was to determine results of IABP use and factors which affect mortality in cardiogenic shock [CS] post CABG. 30 patients [mean age 58.3 +/- 12.6 years, 22 males] undergoing IABP were included in the study. Data were collected and mortality rates were assessed. In-hospital death occurred in 12 patients. Over half of these patients [n = 7; 58.3%] died during first 7 days from insertion of IABP. The reason for IABP introduction was CS post CABG in all patients. The mortality in patients complicated by CS was 40%. The features which significantly influenced mortality in these patients were age-patients who died were older [64 +/- 7.8 Vs. 58.6 +/- 8.2; p = 0.03] and ST segment changes-there was lower mortality rate in a subgroup with ST elevation AMI [8 Vs. 4 patients, p = 0.003]. We also observed slightly higher incidence of anterior wall AMI in survivors than in non-survivors [p = 0.06]. Our study presents CS post CABG treated with IABP. In this study, survivors and non-survivors differed mainly in age, ST segment changes and infarction site. Non ST segment elevation AMI was associated with worse prognosis