0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Research Letter | Less Is More

Use of Intra-aortic Balloon Pump in a Japanese Multicenter Percutaneous Coronary Intervention Registry

Taku Inohara, MD, PhD1; Hiroaki Miyata, PhD2; Ikuko Ueda, PhD1; Yuichiro Maekawa, MD, PhD1; Keiichi Fukuda, MD, PhD1; Shun Kohsaka, MD, PhD1
[+] Author Affiliations
1Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
2Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan
JAMA Intern Med. 2015;175(12):1980-1982. doi:10.1001/jamainternmed.2015.5119.
Text Size: A A A
Published online

Extract

This study investigates the prognostic effect of intra-aortic balloon pump use in Japanese patients undergoing percutaneous coronary intervention for nonacute and acute indications.

We read with interest the recent meta-analysis by Ahmad et al,1 demonstrating a negative association between intra-aortic balloon pump (IABP) therapy and mortality among patients experiencing acute myocardial infarction. We agree that efforts are needed to clarify the role of IABP therapy and to examine its effect on care in other regions and countries. In Japan, IABP therapy is frequently used in patients with guideline-based indications and in patients with less established indications, and the judicious use of invasive procedures has been highlighted.2,3 Our objective herein was to investigate the prognostic effect of IABP use in patients undergoing percutaneous coronary intervention (PCI) for nonacute and acute indications registered in a contemporary multicenter Japanese PCI registry (Japan Cardiovascular Database-Keio Interhospital Cardiovascular Studies4).

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure.
Unadjusted and Adjusted Effects of Intra-aortic Balloon Pump (IABP) Use on In-Hospital Mortality in Various Situations

A and B, Intra-aortic balloon pump use was adversely associated with patient outcome, regardless of situation, in crude (A) and multivariable (B) analyses. In the logistic regression model, adjustments were made using all variables exhibiting a bivariate association with the use of IABP with P < .001 in the Table, which included all variables except the following: diabetes mellitus, previous coronary artery bypass graft, chronic lung disease, stable angina or silent ischemia, and 1-vessel disease. C, For evaluating the baseline inequality index, we redefined a list of the following baseline characteristics that are recognized markers of mortality risk: age, cardiogenic shock, prior heart failure, peripheral vascular disease, chronic lung disease, renal dysfunction, NYHA functional classification of at least 3 at the time of percutaneous coronary intervention, and clinical presentation (STEMI or NSTEMI). LMT indicates left main trunk; NSTEMI, non–ST-segment elevation myocardial infarction; NYHA, New York Heart Association; and STEMI, ST-segment elevation myocardial infarction.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

1,233 Views
5 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed

brightcove.createExperiences();