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August 1, 2011EuroIntervention

Use and impact of intra-aortic balloon pump on mortality in patients with acute myocardial infarction complicated by cardiogenic shock: results of the Euro Heart Survey on PCI

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Why the study?

Does intra-aortic balloon pump improve survival in patients with acute myocardial infarction complicated by cardiogenic shock undergoing PCI?

Population

653 patients with acute myocardial infarction complicated by cardiogenic shock undergoing percutaneous…

Comparison

Intra-aortic balloon pump (IABP) vs No intra-aortic balloon pump (IABP)

Design

Cohort

Follow-up

In-hospital

Key result

Intra-aortic balloon pump use during PCI for acute myocardial infarction with cardiogenic shock was not associated with improved in-hospital survival (OR 1.47; 95% CI 0.97-2.21; p=0.07).

Authors

UZUwe ZeymerTBTimm BauerCHChristian Hamm

Discussion

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Overview

Does not support routine IABP use in AMI-cardiogenic shock PCI; leaves open need for randomized confirmation.

Key Points

  • To evaluate the use and impact of intra-aortic balloon pump counterpulsation on in-hospital mortality in patients undergoing percutaneous coronary intervention for myocardial infarction complicated by cardiogenic shock.
  • Analyzed prospective registry data from 47,407 consecutive patients undergoing percutaneous coronary intervention across 176 centres in 33 countries between May 2005 and April 2008.
  • Identified 653 patients with cardiogenic shock among 8,102 ST-elevation myocardial infarction and 7,999 non-ST elevation myocardial infarction cases to evaluate intra-aortic balloon pump (IABP) utilization and outcomes.
  • An IABP was utilized in 25% of patients with cardiogenic shock (n=653); in-hospital mortality was 56.9% with IABP compared to 36.1% without IABP.
  • Multivariate analysis showed that IABP use was not associated with improved survival (odds ratio 1.47; 95% CI 0.97–2.21, p=0.07).

Study Design

Type

Observational (n=653)

Multicenter

Yes

Structured PICO

Does intra-aortic balloon pump improve survival in patients with acute myocardial infarction complicated by cardiogenic shock undergoing PCI?

P
Population
653 patients with acute myocardial infarction (STEMI or NSTEMI) complicated by cardiogenic shock undergoing percutaneous coronary intervention (PCI), from a registry of 47,407 consecutive PCI patients.
I
Intervention
Intra-aortic balloon pump (IABP)
C
Comparator
No intra-aortic balloon pump (IABP)
O
Outcome
In-hospital mortalityhard clinical

Main Result

Effect estimate: OR 1.47 (95% CI 0.97-2.21)

Absolute Event Rate: 56.9% vs 36.1%

p-value: p=0.07

In real-world practice, the use of an intra-aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock undergoing PCI was not associated with improved in-hospital survival.

Cite This Study

Zeymer et al. (2011) conducted an observational in Acute myocardial infarction complicated by cardiogenic shock (n=653). Intra-aortic balloon pump (IABP) vs. No IABP was evaluated on In-hospital mortality (OR 1.47, 95% CI 0.97-2.21, p=0.07). Intra-aortic balloon pump use during PCI for acute myocardial infarction with cardiogenic shock was not associated with improved in-hospital survival (OR 1.47; 95% CI 0.97-2.21; p=0.07).

synapsesocial.com/papers/6a0a01af87ad1657d251f21chttps://doi.org/10.4244/eijv7i4a72
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impact of intra-aortic balloon pump on long-term mortality of unselected patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock2014 · 11 citations
  2. 2Role of intra-aortic balloon pump counterpulsation in the treatment of acute myocardial infarction complicated by cardiogenic shock: Evidence from the Portuguese nationwide registry2015 · 12 citations
  3. 3The effectiveness of intra-aortic balloon pump for myocardial infarction in patients with or without cardiogenic shock: a meta-analysis and systematic review2016 · 20 citations
  4. 4Cardiovascular Outcomes Using Intra-Aortic Balloon Pump in High-Risk Acute Myocardial Infarction With or Without Cardiogenic Shock2011 · 72 citations
  5. 5Intra-aortic Balloon Pump Therapy for Acute Myocardial Infarction2015 · 134 citations