Tim Kinnaird
Vascular complications associated with intraaortic balloon pump supported percutaneous coronary intervention (PCI) and clinical outcomes from the British Cardiovascular Intervention Society National PCI Database.
Kinnaird, Tim; Anderson, Richard; Gallagher, Sean; Sharp, Andrew S. P.; Farooq, Vasim; Ludman, Peter; Copt, Samuel; Curzen, Nicholas; Sirker, Alex; Nolan, Jim; Mamas, Mamas
Authors
Richard Anderson
Sean Gallagher
Andrew S. P. Sharp
Vasim Farooq
Peter Ludman
Samuel Copt
Nicholas Curzen
Alex Sirker
James Nolan j.nolan@keele.ac.uk
Mamas Mamas m.mamas@keele.ac.uk
Abstract
INTRODUCTION: The impact of a vascular complication (VC) in the setting of intraaortic balloon pump (IABP) supported PCI on clinical outcomes is unclear. METHODS: Using data from the BCIS National PCI Database, multivariate logistic regression was used to identify independent predictors of a VC. Propensity scoring was used to quantify the association between a VC and outcomes. RESULTS: Between 2007 and 2014, 9,970 PCIs in England and Wales were supported by IABP (1.6% of total PCI), with 224 femoral VCs (2.3%). Annualized rates of a VC reduced as the use of radial access for PCI increased. The independent predictors of a VC included a procedural complication (odds ratio [OR] 2.9, p?<?.001), female sex (OR 2.3, p?<?.001), PCI for stable angina (OR 3.47, p = .028), and use of a glycoprotein inhibitor (OR 1.46 [1.1:2.5], p = .04), with a lower likelihood of a VC when radial access was used for PCI (OR 0.48, p = .008). A VC was associated with a higher likelihood of transfusion (OR 5.7 [3.5:9.2], p?<?.0001), acute kidney injury (OR 2.6 [1.2:6.1], p = .027), and periprocedural MI (OR 3.2 [1.5:6.7], p = .002) but not with adjusted mortality at discharge (OR 1.2 [0.8:1.7], p = .394) or 12-months (OR 1.1 [0.76:1.56], p = .639). In sensitivity analyses, there was a trend towards higher mortality in patients experiencing a VC who underwent PCI for stable angina (OR 4.1 [1.0:16.4], p value for interaction .069). Discussion and Conclusions Although in-hospital morbidity was observed to be adversely affected by occurrence of a VC during IABP-supported PCI, in-hospital and 1-year survival were similar between groups.
Journal Article Type | Article |
---|---|
Acceptance Date | Jan 20, 2021 |
Online Publication Date | Feb 8, 2021 |
Publication Date | Jul 1, 2021 |
Publicly Available Date | Mar 29, 2024 |
Journal | Catheterization and Cardiovascular Interventions |
Print ISSN | 1522-1946 |
Publisher | Wiley |
Volume | 98 |
Issue | 1 |
Pages | E53-E61 |
DOI | https://doi.org/10.1002/ccd.29549 |
Keywords | bleeding; complications; intraaortic balloon pump; patient outcomes; vascular complications |
Publisher URL | https://onlinelibrary.wiley.com/doi/10.1002/ccd.29549 |
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc-nd/4.0/
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