Document Detail


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.
MedLine Citation:
PMID:  11376306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
H V Barron; N R Every; L S Parsons; B Angeja; R J Goldberg; J M Gore; T M Chou;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  141     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-05-28     Completed Date:  2001-06-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  933-9     Citation Subset:  AIM; IM    
Affiliation:
University of California, San Francisco, USA. barron.hal@gene.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty
Cohort Studies
Female
Humans
Intra-Aortic Balloon Pumping / statistics & numerical data*
Male
Myocardial Infarction / mortality,  surgery,  therapy
Registries
Retrospective Studies
Shock, Cardiogenic / mortality*,  surgery,  therapy*
Thrombolytic Therapy
United States / epidemiology
Comments/Corrections
Comment In:
Am Heart J. 2001 Jun;141(6):889-92   [PMID:  11376300 ]

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