Prophylactic intra-aortic balloon pump reduces C-reactive protein levels and early mortality in high-risk patients undergoing percutaneous coronary intervention

Abstract

Objective: Intra-aortic balloon pump (IABP) plays a pivotal role in the treatment of cardiogenic shock complicating acute myocardial infarction. However, the usefulness of prophylactic IABP support in high-risk patients during percutaneous coronary intervention (PCI) is still controversial, and its influence on the inflammatory response following PCI has not been well evaluated. In this study we sought to assess the impact of prophylactic IABP support upon C-reactive protein (CRP) level and clinical prognosis in high-risk patients undergoing PCI.

Methods and results: A total of 106 high-risk patients diagnosed with acute ST-elevation or non-ST-elevation myocardial infarction (Cardiogenic shock was excluded) were enrolled and divided into two groups at random: 51 cases receiving PCI accompanied by prophylactic IABP support, and the remaining 55 cases undergoing PCI without IABP insertion served as the control group. CRP levels were determined on admission, day 3 and day 7, respectively. The troponin I (TNI) peak, left ventricular functions and major adverse cardiovascular events (MACE) were compared during follow-up. We found that the IABP group had a lower TNI peak as well as CRP level after PCI. Left ventricular function was improved at 2-week instead of 3-month followup. Although the mortality did not reach a significant decline after 6-month follow-up, it had improved in-hospital and at 30-day follow-up.

Conclusion: The use of a prophylactic IABP in high-risk patients before PCI could reduce the CRP level and reduce mortality during the early phase following PCI.