Benoit Helleu1, Vincent Auffret1, Marc Bedossa1, Martine Gilard2, Vincent Letocart3, Stephan Chassaing4, Denis Angoulvant5, Philippe Commeau6, Grégoire Range7, Fabrice Prunier8, Remi Sabatier9, Emmanuelle Filippi10, Régis Delaunay11, Dominique Boulmier12, Hervé Le Breton12, Guillaume Leurent13. 1. Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France. 2. EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France. 3. L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France. 4. Service de cardiologie interventionnelle et d'imagerie cardiaque, clinique Saint-Gatien, 37000 Tours, France. 5. EA 4245 and Loire Valley Cardiovascular Collaboration, Service de Cardiologie, CHRU de Tours et Université de Tours, 37000 Tours, France. 6. Service de cardiologie, polyclinique les Fleurs, 83190 Ollioules, France. 7. Service de cardiologie, Les hôpitaux de Chartres, 28000 Chartres, France. 8. Institut Mitovasc, UMR CNRS 6015 - INSERM U1083, Service de cardiologie, CHU d'Angers, Université d'Angers, 49100 Angers, France. 9. Cardiology Department, University Hospital of Caen, 14033 Caen, France. 10. Service de cardiologie, centre hospitalier de Vannes, 56000 Vannes, France. 11. Service de cardiologie, centre hospitalier de Saint-Brieuc, 22000 Saint-Brieuc, France. 12. Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France. 13. Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France. Electronic address: guillaume.leurent@chu-rennes.fr.
Abstract
BACKGROUND: Intra-aortic balloon pumps (IABPs) have been used routinely since the 1970s. Recently, large randomized trials failed to show that IABP therapy has meaningful benefit, and international recommendations downgraded its place, particularly in cardiogenic shock. AIMS: The aim of this registry was to describe the contemporary use of IABP therapy, in light of these new data. METHODS: This prospective multicentre registry included 172 patients implanted with an IABP in 19 French cardiac centres in 2015. Baseline characteristics, aetiologies leading to IABP use, and IABP-related and disease-related complications were assessed. In-hospital and 1-year mortality rates were studied. RESULTS: A total of 172 patients were included (mean age 65.5±12.0 years; 118 men [68.6%]). The reasons for IABP implantation were mainly haemodynamic (n=107; 62.2%), followed by bridge to revascularization (n=34; 19.8%) and four other "rare" aetiologies (n=29 patients; 16.8%). In-hospital and 1-year mortality rates were 40.7% and 45.8%, respectively. Fourteen patients (8.1%) experienced ischaemic or haemorrhagic complications, which were directly related to the IABP in seven patients (4.1%). CONCLUSIONS: Despite current international guidelines regarding the place of IABPs in ischaemic cardiogenic shock without mechanical complications, this aetiology remains the leading cause for its utilization in the contemporary era.
BACKGROUND:Intra-aortic balloon pumps (IABPs) have been used routinely since the 1970s. Recently, large randomized trials failed to show that IABP therapy has meaningful benefit, and international recommendations downgraded its place, particularly in cardiogenic shock. AIMS: The aim of this registry was to describe the contemporary use of IABP therapy, in light of these new data. METHODS: This prospective multicentre registry included 172 patients implanted with an IABP in 19 French cardiac centres in 2015. Baseline characteristics, aetiologies leading to IABP use, and IABP-related and disease-related complications were assessed. In-hospital and 1-year mortality rates were studied. RESULTS: A total of 172 patients were included (mean age 65.5±12.0 years; 118 men [68.6%]). The reasons for IABP implantation were mainly haemodynamic (n=107; 62.2%), followed by bridge to revascularization (n=34; 19.8%) and four other "rare" aetiologies (n=29 patients; 16.8%). In-hospital and 1-year mortality rates were 40.7% and 45.8%, respectively. Fourteen patients (8.1%) experienced ischaemic or haemorrhagic complications, which were directly related to the IABP in seven patients (4.1%). CONCLUSIONS: Despite current international guidelines regarding the place of IABPs in ischaemic cardiogenic shock without mechanical complications, this aetiology remains the leading cause for its utilization in the contemporary era.