The use of intra-aortic balloon counterpulsation in patients with cardiogenic shock complicating acute myocardial infarction: data from the National Registry of Myocardial Infarction 2
Authors
Barron, Hal V.Every, Nathan R.
Parsons, Lori S.
Angeja, Brad G.
Goldberg, Robert J.
Gore, Joel M.
Chou, Tony M.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
2001-05-29Keywords
AgedAngioplasty
Cohort Studies
Female
Humans
Intra-Aortic Balloon Pumping
Male
Myocardial Infarction
Registries
Retrospective Studies
Shock, Cardiogenic
Thrombolytic Therapy
United States
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: Cardiogenic shock complicating acute myocardial infarction (AMI) remains the leading cause of death in patients hospitalized with AMI. Although several studies have demonstrated the importance of establishing and maintaining a patent infarct-related artery, it remains unclear as to whether intra-aortic balloon counterpulsation (IABP) provides incremental benefit to reperfusion therapy. The purpose of this study was to determine whether IABP use is associated with lower in-hospital mortality rates in patients with AMI complicated by cardiogenic shock in a large AMI registry. METHODS: We evaluated patients participating in the National Registry of Myocardial Infarction 2 who had cardiogenic shock at initial examination or in whom cardiogenic shock developed during hospitalization (n = 23,180). RESULTS: The mean age of patients in the study was 72 years, 54% were men, and the majority were white. The overall mortality rate in all patients who had cardiogenic shock or in whom cardiogenic shock developed was 70%. IABP was used in 7268 (31%) patients. IABP use was associated with a significant reduction in mortality rates in patients who received thrombolytic therapy (67% vs 49%) but was not associated with any benefit in patients treated with primary angioplasty (45% vs 47%). In a multivariate model, the use of IABP in conjunction with thrombolytic therapy decreased the odds of death by 18% (odds ratio, 0.82; 95% confidence interval, 0.72 to 0.93). CONCLUSIONS: Patients with AMI complicated by cardiogenic shock may have substantial benefit from IABP when used in combination with thrombolytic therapy.Source
Am Heart J. 2001 Jun;141(6):933-9. Link to article on publisher's siteDOI
10.1067/mhj.2001.115295Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47140PubMed ID
11376306Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1067/mhj.2001.115295