Vascular complications associated with intraaortic balloon pump supported percutaneous coronary intervention ( PCI) and clinical outcomes from the British Cardiovascular Intervention Society National PCI Database
Vascular complications associated with intraaortic balloon pump supported percutaneous coronary intervention ( PCI) and clinical outcomes from the British Cardiovascular Intervention Society National PCI Database
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.
bleeding, complications, intraaortic balloon pump, patient outcomes, vascular complications
E53-E61
Kinnaird, Tim
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Anderson, Richard
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Gallagher, Sean
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Sharp, Andrew S. P.
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Farooq, Vasim
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Ludman, Peter
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Copt, Samuel
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Curzen, Nicholas
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Sirker, Alex
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Nolan, Jim
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Mamas, Mamas
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5 July 2021
Kinnaird, Tim
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Anderson, Richard
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Gallagher, Sean
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Sharp, Andrew S. P.
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Farooq, Vasim
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Ludman, Peter
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Copt, Samuel
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Curzen, Nicholas
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Sirker, Alex
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Nolan, Jim
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Mamas, Mamas
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Kinnaird, Tim, Anderson, Richard, Gallagher, Sean, Sharp, Andrew S. P., Farooq, Vasim, Ludman, Peter, Copt, Samuel, Curzen, Nicholas, Sirker, Alex, Nolan, Jim and Mamas, Mamas
(2021)
Vascular complications associated with intraaortic balloon pump supported percutaneous coronary intervention ( PCI) and clinical outcomes from the British Cardiovascular Intervention Society National PCI Database.
Catheterization and Cardiovascular Interventions, 98 (1), .
(doi:10.1002/ccd.29549).
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.
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Cathet Cardio Intervent - 2021 - Kinnaird - Vascular complications associated with intraaortic balloon pump supported
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Accepted/In Press date: 20 January 2021
e-pub ahead of print date: 8 February 2021
Published date: 5 July 2021
Keywords:
bleeding, complications, intraaortic balloon pump, patient outcomes, vascular complications
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Local EPrints ID: 453806
URI: http://eprints.soton.ac.uk/id/eprint/453806
ISSN: 1522-1946
PURE UUID: 15fea730-87f7-4d10-91e3-e722e4e3bdee
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Date deposited: 24 Jan 2022 17:53
Last modified: 17 Mar 2024 03:02
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Author:
Tim Kinnaird
Author:
Richard Anderson
Author:
Sean Gallagher
Author:
Andrew S. P. Sharp
Author:
Vasim Farooq
Author:
Peter Ludman
Author:
Samuel Copt
Author:
Alex Sirker
Author:
Jim Nolan
Author:
Mamas Mamas
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