Six-Month Outcomes After High-Risk Coronary Artery Bypass Graft Surgery and Preoperative Intra-aortic Balloon Counterpulsation Use: An Inception Cohort Study.

摘要: Objective To inform the design of a pivotal randomized controlled trial prophylactic intra-aortic balloon counterpulsation (IABC) in patients undergoing coronary artery bypass graft (CABG) at high risk postoperative low cardiac output syndrome (LCOS). Design Inception cohort study. Setting A total 13 established centers Australia, Canada, New Zealand, and United Kingdom. Participants Adult were eligible for inclusion if they listed CABG surgery had 2 or more LCOS factors (low ejection fraction, severe left main disease, redo sternotomy, unstable angina). Interventions Outcomes interest composite outcome in-hospital mortality, acute myocardial infarction (AMI), kidney injury (AKI), stroke as well 6-month vital status quality life using EuroQol 5-dimensional questionnaire (EQ5D). Measurements Main Results The study included 136 participants over 29-month period. Overall, mortality occurred 7 (5%) 11 (8%) participants, respectively. 60 (44%). mean increase EQ5D summary index 6 months was 0.10 (standard deviation 0.24, p = 0.01). Perioperative AMI, AKI, significantly decreased odds clinically meaningful improvement (odds ratio 0.32; 95% confidence interval 0.13-0.79; 0.014). Preoperative IABC used 39 did not predict outcomes. Conclusions identified group whom associated with substantial burden perioperative morbidity. use variable, supporting need further research.