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Updated: Sep 10, 2025
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Renal and Cardiovascular Outcomes of IABP-Assisted PCI in Renal Dysfunction: A Propensity-Matched Study and MACEs
Zifeng Zeng1,2, Rongtai Luo1,2, Xinping Lan1,2
1Center for Cardiovascular Diseases, Meizhou Academy of Medical Sciences, Meizhou People's Hospital, Meizhou, People's Republic of China.
Background:
The renal safety and cardiovascular outcomes of intra-aortic balloon pump (IABP) support during percutaneous coronary intervention (PCI) in patients with renal dysfunction remain controversial.
Objective:
To investigate the effects of IABP on renal function and major adverse cardiovascular events (MACEs) in PCI patients with renal dysfunction, and to establish an individualized prognostic prediction model.
Methods:
In this retrospective cohort study, 253 PCI patients with renal dysfunction from Meizhou People's Hospital (January-December 2023) were analyzed. Propensity score matching (1:4 IABP/non-IABP) balanced baseline characteristics. Least absolute shrinkage and selection operator (LASSO) regression identified predictors for MACEs, followed by nomogram development and validation.
Results:
Post-matching (IABP = 16, non-IABP = 64), despite higher baseline risk in the IABP group, no intergroup differences occurred in postoperative creatinine, eGFR, or MACEs incidence (all P >0.05). However, this group exhibited greater eGFR decline from baseline. Multivariate analysis identified five independent MACEs predictors: preoperative B-type natriuretic peptide (BNP), postoperative BNP, preoperative neutrophil-to-lymphocyte ratio (NLR), postoperative blood urea nitrogen (BUN), and prealbumin levels. The prediction model achieved AUCs of 0.869 (95% CI: 0.774-0.964) and 0.843 (95% CI: 0.678-1.000) in training and validation sets, with decision curve analysis confirming clinical utility at 10%-80% risk thresholds.
Conclusion:
IABP may exacerbate subclinical renal injury in PCI patients with renal dysfunction without mitigating MACEs risk. The validated nomogram provides individualized risk stratification to guide clinical management.
