A Prospective, Randomized Evaluation of Prophylactic Intraaortic Balloon Counterpulsation in High Risk Patients With Acute Myocardial Infarction Treated With Primary Angioplasty fn1fn1Funding for this study was provided in part by unrestricted grants from Advanced Cardiovascular Systems, Inc., Santa Clara, California; Mallinkrodt Medical, Inc., Saint Louis, Missouri; Datascope Corporation, Montvale, New Jersey; St. Jude Medical, Chelmsford, Massachusetts; and Siemens Corporation, Iselin, New Jersey.

Stone, Gregg W.; Marsalese, Dominic; Brodie, Bruce R.; Griffin, John J.; Donohue, Bryan; Costantini, Costantino; Balestrini, Carlos; Wharton, Thomas P.; Esente, Paolo; Spain, Michael; Moses, Jeffrey W.; Nobuyoshi, Masakiyo; Ayres, Mike; Jones, Denise; Mason, Denise; Grines, Lorelei; O’Neill, William W.; Grines, Cindy L.

doi:10.1016/s0735-1097(97)00088-0

Cited by 246 publications

(33 citation statements)

References 43 publications

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“…Although these studies demonstrated feasibility and suggested efficacy of routine IABP use, their findings have not been supported by data from randomized trials. In randomized trials that enrolled patients with AMI undergoing primary PCI, routine IABP use was not associated with differences in procedural success or clinical outcomes 8, 9, 11, 12 . Collectively, these studies do not support the routine use of IABP for patients at high risk of adverse outcomes, but leaves open the question of how aggressive we should be in using this technology.…”

Section: Discussionmentioning

confidence: 90%

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Curtis

Rathore

Wang

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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Background IABPs are frequently used to provide hemodynamic support during high risk percutaneous coronary intervention (PCI), but clinical evidence to support their use is mixed. We examined hospital variation in IABP use among high risk PCI patients, and determined the association of IABP use on mortality in this population. Methods and Results We analyzed data submitted to the CathPCI Registry® between January 2005 and December 2007. High risk PCI was defined as having at least one of the following features: unprotected left main artery as the target vessel, cardiogenic shock, severely depressed left ventricular function, or ST segment elevation myocardial infarction. Hospitals were categorized into quartiles by their proportional use of IABP. We examined differences in in-hospital mortality across hospital quartiles using a hierarchical logistic regression model to adjust for differences in patient and hospital characteristics across hospital quartiles of IABP use. IABPs were used in 18,990 (10.5%) of 181,599 high risk PCIs. Proportional use of IABP varied significantly across hospital quartiles: Q1: 0.0%–6.5%; Q2: 6.6% to 9.2%; Q3: 9.3% to 14.1%; and Q4: 14.2% to 40.0%. In multivariable analysis, after adjustment for differences in patient and hospital characteristics, in-hospital mortality was comparable across quartiles of hospital IABP usage (Q1: Ref; Q2: Odds Ratio (OR) 1.11, 95% CI 0.99–1.24; Q3: OR 1.03, 95% CI 0.92–1.15; Q4: OR 1.06, 95% CI 0.94–1.18). Conclusion IABP use varied significantly across hospitals for high risk PCI. However, this variation in IABP use was not associated with differences in in-hospital mortality.

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Section: Discussionmentioning

confidence: 90%

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Curtis

Rathore

Wang

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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“…In 1997, the Second Primary Angioplasty in Myocardial Infarction (PAMI-II) trial determined the role of prophylactic IABP therapy after primary angioplasty in AMI patients [12]. This trial enrolled 437 high-risk, but hemodynamically stable patients from 34 centers worldwide.…”

Section: Results From Randomized Clinical Trials Of Iabp Therapy In Amentioning

confidence: 99%

“…In the trial by Kono et al [11], patients were enrolled using a predetermined randomization list along with sealed envelopes. The PAMI-II trial [12] did not state their exact method of randomization. Although there is no direct evidence in either of these three trials of lack of concealment, a situation where a clinician may know in advance that a patient will be allocated to either the treatment or placebo group, this possibility cannot be excluded.…”

Section: Critical Appraisal Of Randomized Clinical Trials Of Iabp Thementioning

confidence: 99%

Systematic review: Intra-aortic balloon counterpulsation pump therapy: a critical appraisal of the evidence for patients with acute myocardial infarction

Peterson

Cook

1998

Crit Care

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“…Stone et al observed a 2.4% stroke rate in patients with AMI randomized to IABP compared to the control group (27). A few other studies have also noted the use of IABP as a predictor for stroke complicating PCI (3,9).…”

Section: Discussionmentioning

confidence: 99%

Temporal Trends in Percutaneous Coronary Intervention–Associated Acute Cerebrovascular Accident (from the 1998 to 2008 Nationwide Inpatient Sample Database)

Shivaraju

Kattan

et al. 2014

The American Journal of Cardiology

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Acute cerebrovascular accident (CVA) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and coronary artery disease (CAD) is associated with high morbidity and mortality. Nationwide Inpatient Sample from 1998 to 2008 was utilized to identify 1,552,602 PCIs performed for ACS and CAD. We assessed temporal trends in the incidence, predictors and prognostic impact of CVA in a broad range of patients undergoing PCI. The overall incidence of CVA was 0.56% (95% confidence interval (CI), 0.55%–0.57%). The incidence of CVA remained unchanged over the study period (adjusted p for trend = 0.2271). The overall mortality in the CVA group was 10.76% (95% CI, 10.1%–11.4%). The adjusted odds ratio (OR) of CVA for in-hospital mortality was 7.74 (95% CI, 7.00–8.57; p<0.0001); this remained high but decreased over the study period (adjusted p for trend <0.0001). Independent predictors of CVA included older age (OR, 1.03, 95% CI, 1.02–1.03; p<0.0001), disorder of lipid metabolism (OR, 1.31, 95% CI, 1.24–1.38; p<0.001), history of tobacco use (OR, 1.21, 95% CI, 1.10–1.34; p=0.0002), coronary atherosclerosis (OR 1.56, 95% CI, 1.43–1.71; p<0.0001), and IABP use (OR 1.39, 95% CI, 1.09–1.77; p=0.0073). A nomogram for predicting the probability of CVA achieved a concordance index of 0.73 and was well calibrated. In conclusion, the incidence of CVA associated with PCI has remained unchanged from 1998–2008 in face of improved equipment, techniques and adjunctive pharmacology. The risk of CVA associated in-hospital mortality is high; however, this risk has declined over the study period.

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Abstract: In contrast to previous studies, a prophylactic IABP strategy after primary PTCA in hemodynamically stable high risk patients with AMI does not decrease the rates of infarct-related artery reocclusion or reinfarction, promote myocardial recovery or improve overall clinical outcome.

Cited by 246 publications

References 43 publications

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Systematic review: Intra-aortic balloon counterpulsation pump therapy: a critical appraisal of the evidence for patients with acute myocardial infarction

Temporal Trends in Percutaneous Coronary Intervention–Associated Acute Cerebrovascular Accident (from the 1998 to 2008 Nationwide Inpatient Sample Database)

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