Akademik Veri Yönetim Sistemi
Heart Surgery Forum, cilt.27, sa.12, ss.1422-1432, 2024 (Scopus)
Background: Early coronary artery bypass grafting
(CABG) in patients with acute myocardial infarction (AMI)
is associated with considerable risk. The optimal timing of
surgery and the preoperative use of an intra-aortic balloon
pump (IABP) in these patients remain unclear. Methods:
To asses the effect of preoperative IABP on troponin levels,
surgical timing, and postoperative outcomes, 230 AMI patients
scheduled for CABG were divided into two groups:
Group A received support with IABP, whereas Group B
served as the control group without IABP. The analysis
evaluated the preoperative reduction in high-sensitivity cardiac
troponin I (hsCTI) levels, timing of surgery, durations
of intensive care unit (ICU) and hospital stays (HS), and
mortality rates. Results: After propensity score matching,
Group A comprised 64 patients with a mean age of 63.1
± 8.9 years, and Group B comprised 92 patients with a
mean age of 65.2 ± 8.1 years. In the IABP group, participants
exhibited relief from angina symptoms, faster reduction
in hsCTI levels, improved transit-time flow measurement
(TTFM) of grafts, and shorter ICU and HS durations.
The overall mortality rate was 7.1%. However, preoperative
IABP support reduced the mortality rate by a factor
of 0.6 compared to intraoperative IABP (β = –0.86; Z =
–2.41; OR = 0.42, 95% CI: 0.2–0.85; p = 0.016). Conclusions:
The IABP provides myocardial preconditioning
in patients with AMI, thus preparing the myocardium for
CABG. Its use should be considered, particularly for highrisk
patients. This study has obtained a clinical registration
number (NCT number: NCT06468982).