Key result
Intra aortic balloon pumping achieved >3-month survival in 40-53% of cardiogenic shock patients and prompt pain relief in 98% of patients with refractory angina, with a 2% lethal complication rate.
Why the study?
Does intra-aortic balloon pumping improve survival and relieve symptoms in patients with myocardial infarction and unstable angina?
Observational (n=181)
Does intra-aortic balloon pumping improve survival and relieve symptoms in patients with myocardial infarction and unstable angina?
IABP is effective for managing pump failure and refractory ischemia in patients with myocardial infarction and unstable angina, though catheter insertion carries a risk of lethal complications.
IABP may aid survival in cardiogenic shock and relieve refractory angina despite lethal risks; leaves open efficacy confirmation in randomized studies.
From 1972 to 1979 intra aortic balloon pumping (IABP) was attempted in 181 patients; catheter insertion failed in 13 (8%). More complications occurred with prolonged treatment but all three lethal complications (2%) were related to catheter insertion. Seventy-six patients had clinical cardiogenic shock after myocardial infarction (CSMI). Haemodynamically, 23 were classified as preshock: 15 (66%) could be weaned, 12 (53%) survived over 3 months; whereas only 27/51 patients (51%) haemodynamically classified as shock could be weaned and 21 (40%) survived over 3 months. Of forty-two patients with refractory angina at rest, 41 had prompt relief of pain after IABP, and subsequently underwent coronary artery bypasss grafting (CABG). Perioperative infarction rate was 8% (4/41), perioperative mortality was 7% (3/41). Total infarction rate was 11% (5/42), and total mortality 7% (3/41). Pain relief was prompt in 14/17 patients (82%) with refractory angina after infarction. Pain persisted in three patients: all three sustained an infarction, one died. Two patients were excluded from surgery. Twelve patients underwent CABG; none died, none developed MI. In eight patients persistence of pain suggested a slowly evolving MI, IABP abolished pain in seven. Conclusion: IABP has demonstrated its efficacy both in pump failure and in refractory ischaemia. However, its use is not without risks.
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Michels et al. (1980) conducted an observational in Myocardial infarction and unstable angina (n=181). Intra aortic balloon pumping (IABP) was evaluated on Clinical outcomes including weaning, survival over 3 months, and pain relief. Intra aortic balloon pumping achieved >3-month survival in 40-53% of cardiogenic shock patients and prompt pain relief in 98% of patients with refractory angina, with a 2% lethal complication rate.
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