TUESDAY, Aug. 24 (HealthDay News) -- Patients who chose to have
a special pump placed in their heart's aorta before undergoing
procedures to open blocked arteries didn't have improved outcomes,
new research shows.
The British study included patients undergoing percutaneous
coronary intervention (PCI), which includes balloon angioplasty
and/or stent placement to open narrowed coronary arteries. The
patients had poor left ventricular function and extensive coronary
disease, which put them at increased risk for ischemia (restricted
blood flow) or arrhythmia (irregular heartbeat) during the
In these high-risk cases, an intra-aortic balloon pump (IABP) is
an option. The pump is connected to a balloon-type device that is
inserted into the descending aorta.
The study findings are published in the Aug. 25 issue of the
Journal of the American Medical Association.
"Observational studies have previously reported that elective IABP insertion may improve outcomes following high-risk PCI. To date, this assertion has not been tested in a randomized trial," study author Dr. Divaka Perera, of King's College London, and colleagues said in a news release from the journal's publisher.
The study included 301 patients. Some opted for IABP insertion
while others decided against it. The primary outcome, which is a
measurement used to determine the effect of the intervention, was
the occurrence of a major adverse cardiac and cardiovascular event
(MACCE). MACCE is defined as death, heart attack, cerebrovascular
event or further revascularization at hospital discharge [up to 28
MACCE at hospital discharge occurred in 15.2 percent of the
patients in the pump group and 16 percent of the no-pump group. The
all-cause death rate six months after hospital discharged was 4.6
percent in the pump group and 7.4 percent in the no-pump group.
"The study did not demonstrate a difference in MACCE at hospital discharge and therefore does not support routine elective IABP insertion before high-risk PCI. However, 12 percent of patients who underwent PCI without elective IABP insertion required rescue IABP support, which highlights the importance of adopting a standby IABP strategy when undertaking high-risk PCI," the researchers concluded.
The Society for Vascular Surgery has more about
angioplasty and stenting.