Featured Research

from universities, journals, and other organizations

Placement of type of pump within the aorta prior to PCI not associated with improved outcomes

Date:
August 24, 2010
Source:
JAMA and Archives Journals
Summary:
High-risk patients undergoing a coronary procedure such as placement of a stent who electively received an intra-aortic balloon pump (a device that can help improve blood flow) prior to the procedure did not experience a significantly lower overall rate of events such as heart attack, revascularization or death, according to a new study.

High-risk patients undergoing a coronary procedure such as placement of a stent who electively received an intra-aortic balloon pump (a device that can help improve blood flow) prior to the procedure did not experience a significantly lower overall rate of events such as heart attack, revascularization or death, according to a study in the August 25 issue of JAMA.

Related Articles


Percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) in patients with impaired left ventricular function can be associated with a significant increased risk of illness or death, and patients with extensive coronary artery disease who may have a diminished reserve to withstand the consequences of ischemia or arrhythmias that may occur during PCI. "In these circumstances, vital hemodynamic support can be provided by an intra-aortic balloon pump (IABP; a special pump connected to a balloon-type device that is inserted into the descending aorta), which simultaneously augments coronary blood flow and decreases myocardial oxygen demand," the authors write. "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."

Divaka Perera, M.D., M.R.C.P., of King's College London, and colleagues conducted the Balloon Pump-Assisted Coronary Intervention Study (BCIS-1) to assess the efficacy and safety of elective IABP use in patients undergoing high-risk PCI. The randomized controlled trial was conducted in 17 tertiary referral cardiac centers in the United Kingdom between December 2005 and January 2009. Patients (n = 301) had severe left ventricular dysfunction and extensive coronary disease. The primary outcome measure was major adverse cardiac and cardiovascular events (MACCE; defined as death, heart attack, cerebrovascular event, or further revascularization at hospital discharge [up to 28 days]).

The researchers found that the primary end point of MACCE at hospital discharge occurred in 15.2 percent of the elective IABP group and 16.0 percent of the no planned IABP group, and all-cause mortality at 6 months was 4.6 percent and 7.4 percent, respectively. Predefined procedural complications occurred more often in the no planned IABP group (16 patients [10.7 percent]) than in the group undergoing elective IABP insertion (2 patients [1.3 percent]). The most common component of these complications was prolonged procedural hypotension (abnormally low blood pressure), which occurred in 13 patients in the group with no planned IABP insertion and 2 patients in the group with elective IABP insertion.

Major or minor bleeding occurred in 19.2 percent of the elective IABP group and 11.3 percent of the no planned IABP group. There was no difference between the groups in the incidence of major bleeding (5 and 6 patients, respectively), but there was more minor bleeding in the elective IABP group (15.9 percent) compared with the no planned IABP group (7.3 percent).

"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 authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Divaka Perera, MD, MRCP; Rodney Stables, DM, FRCP; Martyn Thomas, MD, FRCP; Jean Booth, MSc; Michael Pitt, MD, FRCP; Daniel Blackman, MD, MRCP; Adam de Belder, MD, FRCP; Simon Redwood, MD, FRCP; for the BCIS-1 Investigators. Elective Intra-aortic Balloon Counterpulsation During High-Risk Percutaneous Coronary Intervention A Randomized Controlled Trial. JAMA, 2010;304(8):867-874 DOI: 10.1001/jama.2010.1190

Cite This Page:

JAMA and Archives Journals. "Placement of type of pump within the aorta prior to PCI not associated with improved outcomes." ScienceDaily. ScienceDaily, 24 August 2010. <www.sciencedaily.com/releases/2010/08/100824161501.htm>.
JAMA and Archives Journals. (2010, August 24). Placement of type of pump within the aorta prior to PCI not associated with improved outcomes. ScienceDaily. Retrieved October 30, 2014 from www.sciencedaily.com/releases/2010/08/100824161501.htm
JAMA and Archives Journals. "Placement of type of pump within the aorta prior to PCI not associated with improved outcomes." ScienceDaily. www.sciencedaily.com/releases/2010/08/100824161501.htm (accessed October 30, 2014).

Share This



More Health & Medicine News

Thursday, October 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Reuters - Innovations Video Online (Oct. 29, 2014) A Swedish amputee who became the first person to ever receive a brain controlled prosthetic arm is able to manipulate and handle delicate objects with an unprecedented level of dexterity. The device is connected directly to his bone, nerves and muscles, giving him the ability to control it with his thoughts. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Google To Use Nanoparticles, Wearables To Detect Disease

Google To Use Nanoparticles, Wearables To Detect Disease

Newsy (Oct. 29, 2014) Google X wants to improve modern medicine with nanoparticles and a wearable device. It's all an attempt to tackle disease detection and prevention. Video provided by Newsy
Powered by NewsLook.com
Can Drinking Milk Lead To Early Death?

Can Drinking Milk Lead To Early Death?

Newsy (Oct. 29, 2014) Researchers in Sweden released a study showing heavy milk drinkers face an increased mortality risk from a variety of causes. Video provided by Newsy
Powered by NewsLook.com
Obama: The US Will Not 'run and Hide' From Ebola

Obama: The US Will Not 'run and Hide' From Ebola

AP (Oct. 29, 2014) Surrounded by health care workers in the White House East Room, President Barack Obama said the U.S. will likely see additional Ebola cases in the weeks ahead. But he said the nation can't seal itself off in the fight against the disease. (Oct. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins