Evidence for Overturning the Guidelines in Cardiogenic Shock

Cardiogenic shock complicating acute myocardial infarction continues to be a devastating event associated with extremely high mortality. The results of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial,1 now reported in the Journal, show that in patients with acute myocardial infarction and hemodynamic compromise who undergo revascularization, the routine use of an intraaortic balloon pump (IABP), as compared with standard therapy, does not improve survival.1 Introduced nearly five decades ago,2 IABP is now routinely used as an adjuvant treatment for myocardial infarction complicated by cardiogenic shock, on the basis of evidence that it is associated with hemodynamic . . .