Læknablaðið - feb. 2020, Síða 17

1. Guðbjartsson T, Andersen K, Danielsen R, Geirsson A,
Þorgeirsson G. Yfirlitsgrein um kransæðasjúkdóm - síðari
hluti: Lyfjameðferð, kransæðavíkkun og kransæða-
hjáveituaðgerð. Læknablaðið 2015; 101: 25-35.
2. Sigurjónsson H, Helgadóttir S, Oddsson SJ, Sigurðsson
MI, Geirsson A, Arnórsson Þ, et al. Árangur kransæða-
hjáveituaðgerða á Íslandi 2002-2006. Læknablaðið 2012;
98: 451-6.
3. Okonta K, Anbarasu M, Kanagarajan K. Intra-aortic
balloon pump in coronary artery bypass graft - factors
affecting outcome. J West Afr Coll Surg 2011; 1: 28-40.
4. Parissis H, Graham V, Lampridis S, Lau M, Hooks G,
Mhandu PC. IABP: history-evolution-pathophysiology-
-indications: what we need to know. J Cardiothor Surg
2016; 11: 122.
5. Zacharowski K, Krishna M. Principles of intra-aortic ball-
oon pump counterpulsation. Continuing Educ Anaesthes
Criti Care Pain 2009; 9: 24-8.
6. Parissis H, Soo A, Al-Alao B. Intra aortic balloon pump:
literature review of risk factors related to complications
of the intraaortic balloon pump. J Cardiothor Surg 2011; 6:
147.
7. Elahi MM, Chetty GK, Kirke R, Azeem T, Hartshorne R,
Spyt TJ. Complications Related to Intra-aortic Balloon
Pump in Cardiac Surgery: A Decade Later. Eur J Vasc
Endovasc Surg 2005; 29: 591-4.
8. Gelsomino S, Johnson DM, Lorusso R. Intra-aortic balloon
pump: is the tide turning? Critical care (London, England)
2018; 22: 345.
9. Thiele H, Zeymer U, Neumann F-J, Ferenc M, Olbrich
H-G, Hausleiter J, et al. Intraaortic Balloon Support for
Myocardial Infarction with Cardiogenic Shock. N Engl J
Med 2012; 367: 1287-96.
10. Dharma S, Dakota I, Firdaus I, Wardeh AJ, Jukema JW. The
Use of Intra-aortic Balloon Pump in a Real-World Setting:
A Comparison between Survivors and Nonsurvivors
from Acute Coronary Syndrome Treated with IABP. The
Jakarta Acute Coronary Syndrome Registry. Int J Angiol
2013; 22: 213-22.
11. Thiele H, Zeymer U, Thelemann N, Neumann F-J,
Hausleiter J, Abdel-Wahab M, et al. Intraaortic Balloon
Pump in Cardiogenic Shock Complicating Acute
Myocardial Infarction. Circulation 2019; 139: 395-403.
12. Theologou T, Bashir M, Rengarajan A, Khan O, Spyt T,
Richens D, et al. Preoperative intra aortic balloon pumps
in patients undergoing coronary artery bypass grafting.
Cochrane Database Syst Rev 2011: (1): CD004472.
13. Deppe A-C, Weber C, Liakopoulos OJ, Zeriouh M,
Slottosch I, Scherner M, et al. Preoperative intra-aortic
balloon pump use in high-risk patients prior to coronary
artery bypass graft surgery decreases the risk for morbi-
dity and mortality—A meta-analysis of 9,212 patients. J
Cardiac Surg 2017; 32: 177-85.
14. Garðarsdóttir HR, Árnadóttir LÓ, Aðalsteinsson JA,
Jóhannesdóttir H, Helgadóttir S, Hrafnkelsdóttir ÞJ, et al.
Árangur kransæðahjáveituaðgerða hjá konum á Íslandi.
Læknablaðið 2018; 104: 335-40.
15. Campeau L. Letter: Grading of angina pectoris. Circulation
1976; 54: 522-3.
16. Dolgin M, New York Heart Association. Criteria
Committee. Nomenclature and criteria for diagnosis of
diseases of the heart and great vessels In: Dolgin M, editor.
9 ed. Little, Brown, Boston 1994.
17. Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C,
Goldstone AR, et al. EuroSCORE II. Eur J Cardio-thor Surg
2012; 41: 734-44; discussion 44-5.
18. RStudio Team. RStudio: Integrated Development for R.
RStudio, Inc, Boston 2016.
19. Dietl CA, Berkheimer MD, Woods EL, Gilbert CL, Pharr
WF, Benoit CH. Efficacy and cost-effectiveness of preoper-
ative IABP in patients with ejection fraction of 0.25 or less.
Ann Thorac Surg 1996; 62: 401-8; discussion 8-9.
20. Danielsen R, Guðnason Þ, Guðmundsdóttir IJ.
Kransæðavíkkun. In: Guðbjartsson T, Þorgeirsson G, ritstj.
Kransæðabókin. Reykjavík 2016.
21. Perera D, Stables R, Thomas M, Booth J, Pitt M, Blackman
D, et al. Elective Intra-aortic Balloon Counterpulsation
During High-Risk Percutaneous Coronary Intervention: A
Randomized Controlled Trial. JAMA 2010; 304: 867-74.
22. Amin AP, Spertus JA, Curtis JP, Desai N, Masoudi FA,
Bach RG, et al. The Evolving Landscape of Impella®
Use in the United States Among Patients Undergoing
Percutaneous Coronary Intervention with Mechanical
Circulatory Support. Circulation 2019 Nov 17.
23. Schrage B, Ibrahim K, Loehn T, Werner N, Sinning
J-M, Pappalardo F, et al. Impella Support for Acute
Myocardial Infarction Complicated by Cardiogenic Shock.
Circulation. 2019; 139: 1249-58.
24. Shirzad M, Karimi A, Tazik M, Aramin H, Hossein
Ahmadi S, Davoodi S, et al. Determinants of postoperative
atrial fibrillation and associated resource utilization in
cardiac surgery. Rev Espan Cardiologia 2010; 63: 1054-60.
25. Su D, Yan B, Guo L, Peng L, Wang X, Zeng L, et al. Intra-
aortic balloon pump may grant no benefit to improve the
mortality of patients with acute myocardial infarction in
short and long term: an updated meta-analysis. Medicine
2015; 94: e876-e.
26. Dziewierz A, Siudak Z, Rakowski T, Kleczyński P,
Zasada W, Dudek D. Impact of intra-aortic balloon
pump on long-term mortality of unselected patients with
ST-segment elevation myocardial infarction complicated
by cardiogenic shock. Postepy Kardiol Interwencyjnej
2014; 10: 175-80.
27. Wan Y-D, Sun T-W, Kan Q-C, Guan F-X, Liu Z-Q, Zhang
S-G. The Effects of Intra-Aortic Balloon Pumps on
Mortality in Patients Undergoing High-Risk Coronary
Revascularization: A Meta-Analysis of Randomized
Controlled Trials of Coronary Artery Bypass Grafting and
Stenting Era. PloS one 2016; 11: e0147291-e.
28. Rampersad PP, Udell JA, Zawi R, Ouzounian M,
Overgaard CB, Sharma V, et al. Preoperative Intraaortic
Balloon Pump Improves Early Outcomes Following High-
Risk Coronary Artery Bypass Graft Surgery: A Meta-
Analysis of Randomized Trials and Prospective Study
Design. J Invasive Cardiol 2018; 30: 2-9.
29. Rampersad PP, Zawi R, Overgaard CB, Ouzounian M,
Sharma V, Rao V, et al. Preoperative intra-aortic balloon
pump (IABP) decreases mortality and major adverse
cardiovascular and cerebrovascular events (MACCE) in
high-risk coronary artery bypass (CABG) patients. Can J
Cardiol 2015; 31: S179-S80.
30. Wilczynski M, Krzych LJ, Bis J, Szmagala P, Ulczok R,
Bochenek A. Effect of gender on efficacy of preoperative
intra-aortic balloon pump in high risk patients und-
ergoing surgical coronary revascularisation. Kardiol Pol
2010; 68: 1361-8.
31. Valente S, Lazzeri C, Crudeli E, Chiostri M, Giglioli C,
Bernardo P, et al. Intraaortic balloon pump: incidence
and predictors of complications in the Florence registry.
Clinical cardiol 2012; 35: 200-4.
32. Krishna M, Zacharowski K. Principles of intra-aortic ball-
oon pump counterpulsation. BJA Education 2009; 9: 24-8.
Heimildir
LÆKNAblaðið 2020/106 69
R A N N S Ó K N
búa til viðmiðunarhóp sem væri sambærilegur með tilliti til bak-
grunns sjúklinganna fyrir aðgerð. Pörunin reyndist ekki möguleg
vegna smæðar gagnagrunnsins.
Styrkleikar rannsóknarinnar eru að gagnagrunnurinn geymir
ítarlegar upplýsingar um hvern og einn sjúkling en hann tekur
til allra sjúklinga sem gengust undir kransæðahjáveituaðgerð
hjá heilli þjóð á 18 ára tímabili. Auk þess voru aðgerðirnar fram-
kvæmdar á einni stofnun af tiltölulega fáum læknum, sem tryggir
einsleitari sjúklingahóp og samræmi á milli aðgerða. Loks er
styrkleiki að eftirfylgd var 100% og brottfall sjúklinga með tilliti
til lifunar því hverfandi.
Rannsóknin sýnir að innan við 5% sjúklinga fá ósæðardælu
í tengslum við kransæðahjáveitu á Íslandi. Algengasti áhættu-
þáttur fyrir notkun dælunnar var alvarleg hjartabilun þar sem
útstreymisbrot vinstri slegils var verulega skert, eða undir 30%
(eðlilegt 50-60%). Tíðni fylgikvilla og 30 daga dánartíðni voru eins
og búast mátti við hærri hjá sjúklingum sem fengu ósæðardælu,
og langtíma- og MACCE-frí lifun þeirra umtalsvert síðri, sem
skýrist helst af því að þessir sjúklingar voru mun veikari fyrir að-
gerðina frekar en að það megi reka til notkunar ósæðardælunnar.
Þessi rannsókn svarar því ekki hvort ósæðardæla sé gagnleg eða
skaðleg hjá þessum sjúklingum, enda ekki framskyggn. Frekari
rannsóknir með stærri sjúklingaefnivið þarf til þess, og þar væri
framskyggn rannsókn æskileg.
Þakkir
Þakkir fá læknar á hjarta- og lungnaskurðdeild Landspítala og á
gjörgæsludeild. Rannsóknin var styrkt af Vísindasjóði Landspít-
ala, Rannsóknarsjóði Háskóla Íslands og Minningarsjóði Helgu
Jónsdóttur og Sigurliða Kristjánssonar.
Greinin barst til blaðsins 18. október, samþykkt til birtingar 3. janúar 2020.