Effect of Timing of IABP Application for Emergency PCI on Inflammatory Factors,Left Ventricular Function,and Prognosis in Patients with ACS Combined with Cardiogenic Shock

XU Kai; LIU Li; QIN Guofeng; WANG Huiming; ZHANG Yanzhen

doi:10.12102/j.issn.1672-1349.2025.03.017

Abstract：Objective: To explore the effect of the timing of intra-aortic balloon pump (IABP) use during emergency percutaneous coronary intervention (PCI) on inflammatory factors, left ventricular function, and major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) complicated by cardiogenic shock. Methods: A total of 70 patients with ACS complicated by cardiogenic shock who underwent emergency PCI with IABP support at Weifang Sunlight Ronghe Hospital from April 2020 to March 2022 were selected and divided into two groups based on the timing of IABP application: pre-intervention group and post-intervention group, each with 35 cases. Hemodynamic parameters [pulmonary capillary wedge pressure (PCWP), invasive systolic blood pressure (SBP), invasive mean arterial pressure (MABP)], inflammatory factors [high-sensitivity C-reactive protein (hs-CRP), soluble CD40 ligand (sCD40L), interleukin-6 (IL-6)], left ventricular function [left ventricular ejection fraction (LVEF), cardiac index, left ventricular end-diastolic diameter (LVEDD), cardiac output], N-terminal pro-B-type natriuretic peptide (NT-proBNP), simplified acute physiology score II (SAPS II), acute physiology and chronic health evaluation II (APACHE II), serum creatinine (SCr), complications, and MACE were compared between the two groups. Results: There was no statistically significant difference in PCWP, SBP, and MABP immediately after treatment between the two groups (P > 0.05). At 6 hours and 24 hours after treatment, the levels of hs-CRP, sCD40L, IL-6, NT-proBNP, SAPS II score, and SCr were lower in the pre-intervention group than in the post-intervention group (P < 0.05). There was no statistically significant difference in APACHE II scores at 6 hours and 24 hours after treatment between the two groups (P > 0.05). At 1 month and 6 months after treatment, there was no statistically significant difference in LVEF, cardiac index, LVEDD, and cardiac output between the two groups (P > 0.05). The total incidence of complications showed no statistically significant difference between the pre-intervention group and the post-intervention group (P > 0.05). After a 1-month follow-up, the total incidence of MACE was 5.71% in the pre-intervention group, which was lower than 22.86% in the post-intervention group (P < 0.05). After a 6-month follow-up, there was no statistically significant difference in the total incidence of MACE between the two groups (P > 0.05). Conclusion: Compared with the use of IABP after emergency PCI, the use of IABP before PCI can reduce the inflammatory response in patients with ACS complicated by cardiogenic shock, improve postoperative cardiac function, renal function, and short-term prognosis, without increasing the risk of complications. However, the timing of IABP application has no significant effect on hemodynamics, left ventricular function, or long-term prognosis.