title: [Clinical efficacy of intra-aortic balloon pumping in treating patients with acute myocardial infarction with left main coronary artery disease].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intra-aortic balloon pump (IABP) counter pulsation in the treatment of ST-segment elevation myocardial infarction (STEMI) with concurrent left main coronary artery (LMCA) disease.
  
  
  METHODS
  A retrospective analysis was performed on 305 patients with confirmed STEMI due to LMCA occlusion (≥ 50%) by coronary angiography. They were divided into IABP and non-IABP groups according to the application of IABP or not. Two groups were further divided into 2 subgroups according to the treatment with percutaneous coronary intervention (PCI) or drug alone. Short and long-term clinical efficacies and the incidence of complications caused by the application of IABP were analyzed in all groups and subgroups.
  
  
  RESULTS
  (1) PCI procedure: Successful rate of immediate post-procedure was 100%. No death, major cardiovascular event and cerebrovascular accident occurred during the procedure. The average number of stents per patient was 2.1 ± 0.7 and the average diameter and length of stent were (3.9 ± 0.6) and (24.2 ± 7.1) mm respectively. (2) SAFETY: No significant difference existed between the IABP and non-IABP groups in in-hospital massive bleeding rate (0.94% vs 1.00%, P > 0.05). However, the IABP group had a higher prevalence of mild in-hospital bleeding than the non-IABP group. (3) In-hospital and long-term major adverse cardiac event (MACE) rate: (1) IABP group had a lower MACE rate (25.3% (24/95) vs 38.5% (57/148), P < 0.05). (2) In spite of IABP implantation, the PCI subgroup had significantly a lower mortality rate than the drug subgroup (7.2% (6/83) vs 25.0% (6/24), P < 0.05). (3) The combined use of PCI and IABP was superior to other regimens with regards to decreasing short and long-term mortality (11.2% (12/107) and 25.3% (50/198), P < 0.01).
  
  
  CONCLUSIONS
  PCI is feasible and safe for the STEMI patients with LMCA and better short and long-term efficacies may be achieved. The use of IABP in the treatment of LMCA-related STEMI reduces MACE rate and improves survival rate.
authors.affiliation: Department of Cardiology, Institute of Cardiovascular Research of People's Liberation Army, General Hospital of Shenyang Military Region, Shenyang 110840, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.forename: Ya-ling
authors.initials: YL
authors.lastname: Han
authors.forename: Shou-li
authors.initials: SL
authors.lastname: Wang
authors.forename: Xiao-zeng
authors.initials: XZ
authors.lastname: Wang
authors.forename: Quan-min
authors.initials: QM
authors.lastname: Jing
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Geng
authors.initials: G
authors.lastname: Wang
authors.forename: Ying-yan
authors.initials: YY
authors.lastname: Ma
authors.forename: Hai-wei
authors.initials: HW
authors.lastname: Liu
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome