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To evaluate a 30-day and long-term outcome of patients with acute myocardial infarction (AMI) treated with intra-aortic balloon pump (IABP) counterpulsation and to identify predictors of a 30-day and long-term all-cause mortality.
Retrospective cohort study of 437 consecutive AMI patients treated with IABP between January 1990 and June 2004. A Cox proportional hazards model was used to identify predictors of a 30-day and long-term all-cause mortality.
Mean age of the study population was 61 ± 11 years, 80% of the patients were male, and 68% had cardiogenic shock. Survival until IABP removal after successful haemodynamic stabilisation was 78% (n = 341). Cumulative 30-day survival was 68%. Median follow-up was 2.9 years (range, 6 months to 15 years). In patients who survived until IABP removal, cumulative 1-, 5-, and 10-year survival was 75%, 61%, and 39%, respectively. Independent predictors of higher long-term mortality were prior cerebrovascular accident (hazard ratio (HR), 1.8; 95% confidence interval (CI), 1.0–3.4), need for antiarrhythmic drugs (HR, 2.3; 95% CI, 1.5–3.3), and need for renal replacement therapy (HR, 2.3; 95% CI, 1.2–4.3). Independent predictors of lower long-term mortality were primary percutaneous coronary intervention (PCI; HR, 0.6; 95% CI, 0.4–1.0), failed thrombolysis with rescue PCI (HR, 0.5; 95% CI, 0.3–0.9), and coronary artery bypass grafting (HR, 0.3; 95% CI, 0.1–0.5).
Despite high in-hospital mortality in patients with AMI treated with IABP, a favourable number of patients survived in the long-term. These results underscore the value of aggressive haemodynamic support of patients throughout the acute phase of AMI.
Kantrowitz A, Tjonneland S, Freed PS, et al. Initial clinical experience with intra-aortic balloon pumping in cardiogenic shock. JAMA. 1968;203:135–40.
Kern MJ, Aguirre F, Bach R, et al. Augmentation of coronary blood flow by intra-aortic balloon pumping in patients after coronary angioplasty. Circulation. 1993;87:500–11. PubMed
Sanborn TA, Sleeper LA, Bates ER, et al. Impact of thrombolytic, intra- aortic balloon pump counterpulsation, and their combination in cardiogenic shock complicating acute myocardial infarction: a report from the SHOCK Trial Registry. Should we emergently revascularize Occluded Coronaries for cardiogenic shocK? J Am Coll Cardiol. 2000;36(3 Suppl A):1123–9. PubMedCrossRef
Hochman JS, Buller CE, Sleeper LA, et al. Cardiogenic shock complicating acute myocardial infarction- etiologies, management and outcome: a report from the SHOCK Trial Registry. Should we emergently revascularize Occluded Coronaries for cardiogenic shock? J Am Coll Cardiol. 2000;36(3 suppl A):1063–70. PubMedCrossRef
Collier PE, Liebler GA, Park SB, et al. Is percutaneous insertion of intra-aortic balloon through the femoral artery the safest technique? J Vasc Surg. 1986;3(4):629–34. PubMed
- Encouraging survival rates in patients with acute myocardial infarction treated with an intra-aortic balloon pump
S. D. A. Valk
J. M. Cheng
C. A. den Uil
W. K. Lagrand
M. van der Ent
M. van de Sande
R. T. van Domburg
M. L. Simoons
- Bohn Stafleu van Loghum