What is the clinical evidence from this study?

Study design: Observational. Population: ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (n=51). Intervention: Intra-aortic balloon pump (IABP) vs. No intra-aortic balloon pump. Primary outcome: 1-year all-cause mortality (adjusted OR 1.27, 95% CI 0.32-5.09, p=0.74).

January 1, 2014Advances in Interventional CardiologyOpen Access

Impact of intra-aortic balloon pump on long-term mortality of unselected patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock

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Why the study?

Does the use of an intra-aortic balloon pump reduce 1-year mortality in unselected patients with STEMI complicated by cardiogenic shock?

Population

51 unselected patients with ST-segment elevation myocardial infarction presenting in cardiogenic shock on…

Comparison

Intra-aortic balloon pump applied at the… vs Treatment without intra-aortic balloon pump.

Design

Cohort

Follow-up

1 year

Key result

Intra-aortic balloon pump support did not significantly impact 1-year mortality compared to no support in unselected patients with STEMI complicated by cardiogenic shock (adjusted OR 1.27).

Authors

ADArtur Dziewierz ZSZbigniew Siudak TRTomasz Rakowski

Discussion

Member takes

Overview

Does not support IABP in unselected STEMI shock; leaves open its role in selected patients pending randomized data.

Study Design

Type

Observational (n=51)

Multicenter

Yes

Structured PICO

Does the use of an intra-aortic balloon pump reduce 1-year mortality in unselected patients with STEMI complicated by cardiogenic shock?

Population

51 unselected patients with STEMI complicated by cardiogenic shock on admission, treated with primary percutaneous coronary intervention and followed for 1 year.

Exposure

Intra-aortic balloon pump (IABP) applied at the discretion of the operators (n=30).

Comparator

Treatment without intra-aortic balloon pump (no-IABP) (n=21).

Outcome

1-year mortalityhard clinical

Main Result

Odds Ratio: 1.27 (95% CI 0.32–5.09)

Absolute Event Rate: 33.3% vs 42.9%

p-value: p=0.74

In a real-world registry of unselected STEMI patients complicated by cardiogenic shock, the use of an intra-aortic balloon pump did not improve 30-day or 1-year mortality, confirming findings from randomized clinical trials.

Limitations

Non-randomised study with potential selection bias
Groups were not balanced for important factors affecting long-term outcomes (gender, age, infarct location, and diabetes mellitus)
Very small sample size, leaving the study underpowered for the assessment of clinical endpoints
Unable to calculate propensity scores or control for all patient-, operator-, and centre-related factors
No data on the timing of IABP insertion (before, during, or after angiography/PCI)
No data on the use of antithrombotic/antiplatelet drugs, inotropes/vasopressors, or admission laboratory predictors of mortality

Cite This Study

Dziewierz et al. (2014) conducted an observational in ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (n=51). Intra-aortic balloon pump (IABP) vs. No intra-aortic balloon pump was evaluated on 1-year all-cause mortality (adjusted OR 1.27, 95% CI 0.32-5.09, p=0.74). Intra-aortic balloon pump support did not significantly impact 1-year mortality compared to no support in unselected patients with STEMI complicated by cardiogenic shock (adjusted OR 1.27).

synapsesocial.com/papers/6aa1ffa6c821ca26ad46ea87 https://doi.org/10.5114/pwki.2014.45144

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January 1, 2014Advances in Interventional CardiologyOpen Access

Impact of intra-aortic balloon pump on long-term mortality of unselected patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock

View Full Paper

Ask AI

Bookmark

Why the study?

Does the use of an intra-aortic balloon pump reduce 1-year mortality in unselected patients with STEMI complicated by cardiogenic shock?

Population

51 unselected patients with ST-segment elevation myocardial infarction presenting in cardiogenic shock on…

Comparison

Intra-aortic balloon pump applied at the… vs Treatment without intra-aortic balloon pump.

Design

Cohort

Follow-up

1 year

Key result

Intra-aortic balloon pump support did not significantly impact 1-year mortality compared to no support in unselected patients with STEMI complicated by cardiogenic shock (adjusted OR 1.27).

Authors

ADArtur Dziewierz ZSZbigniew Siudak TRTomasz Rakowski

Discussion

Member takes

Overview

Does not support IABP in unselected STEMI shock; leaves open its role in selected patients pending randomized data.

Study Design

Type

Observational (n=51)

Multicenter

Yes

Structured PICO

Does the use of an intra-aortic balloon pump reduce 1-year mortality in unselected patients with STEMI complicated by cardiogenic shock?

Population

51 unselected patients with STEMI complicated by cardiogenic shock on admission, treated with primary percutaneous coronary intervention and followed for 1 year.

Exposure

Intra-aortic balloon pump (IABP) applied at the discretion of the operators (n=30).

Comparator

Treatment without intra-aortic balloon pump (no-IABP) (n=21).

Outcome

1-year mortalityhard clinical

Main Result

Odds Ratio: 1.27 (95% CI 0.32–5.09)

Absolute Event Rate: 33.3% vs 42.9%

p-value: p=0.74

Limitations

Non-randomised study with potential selection bias
Groups were not balanced for important factors affecting long-term outcomes (gender, age, infarct location, and diabetes mellitus)
Very small sample size, leaving the study underpowered for the assessment of clinical endpoints
Unable to calculate propensity scores or control for all patient-, operator-, and centre-related factors
No data on the timing of IABP insertion (before, during, or after angiography/PCI)
No data on the use of antithrombotic/antiplatelet drugs, inotropes/vasopressors, or admission laboratory predictors of mortality

Cite This Study

synapsesocial.com/papers/6aa1ffa6c821ca26ad46ea87 https://doi.org/10.5114/pwki.2014.45144

Also Consider

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