Die intraaortale Ballongegenpulsation bei Patienten mit akutem Koronarsyndrom und reduzierter linksventrikulärer Pumpfunktion

Abstract

Patients and methods: One-hundred fifty patients with acute coronary syndrome and reduced left-ventricular function were studied during a time period of two years. Only those patients were included in the analysis who also had had a coronary revascularization procedure followed by implantation of an intra-aortic balloon pump (IABP). The analysis included individual patient characteristics, circulation parameters, catecholamine therapy, lab results and complications such as invasive mechanical ventilation, dialysis or haemofiltration, or complications associated with the use of the IABP. Results: Letality was not significantly influenced by the form of the acute coronary syndrome, i. e. whether it was an ST-elevation myocardial infarction or a non-ST-elevation myocardial infarction. Furthermore, left-ventricular function did not differ between the two forms of acute coronary syndrome. For the whole study population, the intra-hospital letality and the 1-year letality were 24 % and 29 %, respectively. Multivariate analysis revealed invasive mechanical ventilation and haemofiltration due to renal failure as predictors of intra-hospital letality with an ODDS ratio of 1:24 and 1:4.3, respectively. Both parameters do not represent independent disease entities but reflect the haemodynamic situation of the acute coronary syndrome. Conclusion: The treatment of patients with acute coronary syndrome still represents an intensive-medical challenge. The major goal is to prevent multi-organ failure.