Effect of circulatory assistance on premature death and long-term prognosis.
BACKGROUND
Patients undergoing urgent heart transplantation (HT) have a poorer prognosis and more long-term complications. The objective of this study was to compare the preoperative course in patients undergoing urgent HT according to the need for preoperative intra-aortic balloon counterpulsation (IABP).


METHODS
We studied 102 consecutive patients including 23 patients with IABP who underwent urgent HT between January 2000 and September 2006. We excluded patients who received combination transplants, those who underwent repeat HT, and pediatric patients who underwent HT. The statistical methods used were the t test for quantitative variables and the chi(2) test for qualitative variables. A logistic regression model was constructed to assess the possible relationship between IABP and other variables on premature death within 30 days after HT.


RESULTS
Mean (SD) patient-age was 50 (10) years. No significant differences were observed in baseline characteristics between the IABP and the non-IAPB groups. The IABP patient group had higher rates of acute graft failure (45.5% vs 35.4%; P = .46) and premature death (18.8% vs 14.8%; P = .67) and shorter long-term survival (40.6 [34.9] vs 54.5 [43.7] mo; P = .30). Multivariate analysis demonstrated no association between the need for IABP and increased frequency of premature death.


CONCLUSIONS
Use of IABP is not associated with premature or late death. We recommend use of IABP in patients with acute decompensated heart failure to stabilize them before HT.
Sánchez Lázaro
I J
IJ
Heart Failure and Transplantation Unit, Department of Cardiology, La Fe University Hospital, Valencia, Spain. igsania@comv.es
Almenar Bonet
L
L
Martínez-Dolz
L
L
Moro López
J
J
Rueda Soriano
J
J
Arnau Vives
M A
MA
Buendía Fuentes
F
F
Ortiz Martínez
V
V
Cano Pérez
O
O
Sánchez Soriano
R
R
Salvador Sanz
A
A
D000328:Adult; D016027:Heart Transplantation / Q000401:mortality* / Q000502:physiology*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008875:Middle Aged; D018579:Patient Selection; D011300:Preoperative Care; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000628:therapy; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome