Universität zu Köln

Deppe, Antje-Christin, Weber, Carolyn, Liakopoulos, Oliver J., Zeriouh, Mohamed, Slottosch, Ingo, Scherner, Maximilian, Kuhn, Elmar W., Choi, Yeong-Hoon and Wahlers, Thorsten (2017). Preoperative intra-aortic balloon pump use in high-risk patients prior to coronary artery bypass graft surgery decreases the risk for morbidity and mortality-A meta-analysis of 9,212 patients. J. Card. Surg., 32 (3). S. 177 - 186. HOBOKEN: WILEY. ISSN 1540-8191

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Abstract

AIMS: Prophylactic intra-aortic balloon pump (IABP) support for high-risk patients before coronary artery bypass grafting (CABG) is controversial. This meta-analysis sought to determine the current role of preoperative IABP support. METHODS: Weperformed a meta-analysis of randomized (RCT) and observational trials (OT) that fulfilled the following criteria: (1) Group comparison of patients with prophylactic IABP implantation before CABG with a control group; (2) reporting at least one desired clinical endpoint, including all-cause mortality, myocardial infarction, cerebrovascular accident (CVA), and renal failure. Pooled treatment effects (odds ratio [OR] or weighted mean difference, and 95% confidence intervals [95% CI]) were assessed using a fixed or random effects model. RESULTS: A total of 9,212 patients from 23 studies (7 RCT, 16 OT) were identified after a literature search of major databases using a predefined keyword list. Absolute risk reduction for mortality in RCTs was 4.4% (OR 0.43; 95% CI 0.25-0.73; p = 0.0025). Prophylactic IABP use before CABG surgery also decreased the risk for myocardial infarction (OR 0.58; 95% CI 0.43-0.78; p = 0.004), CVA (OR 0.67; 95% CI 0.47-0.97; p = 0.042), and renal failure (OR 0.62; 95% CI 0.47-0.83; p = 0.0014). Length of intensive care unit stay (p < 0.0001) and length of hospital stay (p < 0.0001) were significantly reduced in patients with preoperative IABP use. CONCLUSION: Current evidence from RCT and OT suggests beneficial effects for the IABP in high-risk patients before CABG surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Deppe, Antje-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-239102
DOI:	10.1111/jocs.13114
Journal or Publication Title:	J. Card. Surg.
Volume:	32
Number:	3
Page Range:	S. 177 - 186
Date:	2017
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1540-8191
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE MYOCARDIAL-INFARCTION; RANDOMIZED CLINICAL-TRIAL; LEFT-VENTRICULAR FUNCTION; CARDIOGENIC-SHOCK; OFF-PUMP; CARDIAC-SURGERY; EARLY REVASCULARIZATION; COUNTERPULSATION; EFFICACY; SUPPORT Multiple languages Cardiac & Cardiovascular Systems; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23910