Effects of intra-aortic balloon pump on in-hospital outcomes and 1-year mortality in patients with acute myocardial infarction complicated by cardiogenic shock

Fang, Dingfeng; Yu, Dongdong; Xu, Jiabin; Ma, Wei; Zhong, Yuxiang; Chen, Haibo

doi:10.1186/s12872-023-03465-8

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…Over the past years, numerous mechanical circulatory support (MCS) devices have emerged to stabilize circulation and support the heart in these patients [ 4 ]. However, strategies such as intra-aortic balloon pumping (IABP) have not proven effective, and there is little information regarding the effectiveness of other MCS devices in CS [ 5 , 6 ].…”

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confidence: 99%

Efficacy and safety of extracorporeal membrane oxygenation for cardiogenic shock complicating myocardial infarction: a systematic review and meta-analysis

Elsaeidy,

Taha,

Abuelazm

et al. 2024

BMC Cardiovasc Disord

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Background Extracorporeal membrane oxygenation (ECMO) has been presented as a potential therapeutic option for patients with cardiogenic shock complicating myocardial infarction (CS-MI). We aimed to investigate the efficacy and safety of ECMO in CS-MI. Methods A systematic review and meta-analysis synthesizing evidence from randomized controlled trials obtained from PubMed, Embase, Cochrane, Scopus, and Web of Science until September 2023. We used the random-effects model to report dichotomous outcomes using risk ratio and continuous outcomes using mean difference with a 95% confidence interval. Finally, we implemented a trial sequential analysis to evaluate the reliability of our results. Results We included four trials with 611 patients. No significant difference was observed between ECMO and standard care groups in 30-day mortality with pooled RR of 0.96 (95% CI: 0.81–1.13, p = 0.60), acute kidney injury (RR: 0.65, 95% CI: 0.41–1.03, p = 0.07), stroke (RR: 1.16, 95% CI: 0.38–3.57, p = 0.80), sepsis (RR: 1.06, 95% CI: 0.77–1.47, p = 0.71), pneumonia (RR: 0.99, 95% CI: 0.58–1.68, p = 0.96), and 30-day reinfarction (RR: 0.95, 95% CI: 0.25–3.60, p = 0.94). However, the ECMO group had higher bleeding events (RR: 2.07, 95% CI: 1.44–2.97, p < 0.0001). Conclusion ECMO did not improve clinical outcomes compared to the standard of care in patients with CS-MI but increased the bleeding risk.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of extracorporeal membrane oxygenation for cardiogenic shock complicating myocardial infarction: a systematic review and meta-analysis

Elsaeidy,

Taha,

Abuelazm

et al. 2024

BMC Cardiovasc Disord

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A multivariate and retrospective analysis of the impact of intra-aortic balloon counterpulsation in Open-Heart surgery

Sharma,

Nah,

Siddarth

et al. 2024

Sci Rep

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Background The use of intraaortic balloon pump (IABP) effectively reduces left ventricular afterload and significantly increases coronary perfusion pressure by raising aortic diastolic pressure. This study examined the short and medium-term outcomes of 22,540 adult cardiac surgical patients requiring an IABP. Methods From 2009 to 2018, 1114 patients (4.94%) undergoing open-heart surgery at a single tertiary cardiac hospital received IABP support and were included in this retrospective study. They were categorized into pre-operative (Group A, n = 577), intra-operative (Group B, n = 475), and post-operative (Group C, n = 62) IABP insertion groups. Results Cardiogenic shock occurred in 11.2% of cases, mainly in Group A. Hemodynamic instability (38.8%) drove IABP use in Groups A and C, while difficulty weaning from CPB was the primary reason in Group C. The overall operative mortality rate was 10.9%, highest at 25.8% postoperatively. Multivariate analysis identified significant predictors of mortality: age (OR: 1.067, 95% CI: 1.041–1.094, p < 0.001), higher BMI (OR: 1.071, 95% CI: 1.017–1.128, p = 0.009), pulmonary hypertension (OR: 2.085, 95% CI: 1.302–3.341, p = 0.002), renal disease (OR: 2.780, 95% CI: 1.556–4.967, p < 0.001), and cardiogenic shock (OR: 3.684, 95% CI: 2.066–6.569, p < 0.001). Complications were more common in Group C, especially with renal disease. Average preoperative and postoperative stays were 4.0 ± 4.8 days and 15.2 ± 20.4 days, respectively, with no significant differences between groups. Conclusion IABP might offer safety for open-heart surgery, with longer hospital stays potentially associated with high-risk patients. Pre-operative IABP prophylaxis could be crucial in high-risk open-heart cases to reduce mortality. Clinical registration number: NHG DSRB Ref No# 2016/01070 and 2019/00397. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-81056-z.

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Development and Validation of a Nomogram for Predicting Survival in Patients With Cardiogenic Shock

Fang,

Chen,

Geng

et al. 2024

Preprint

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Background: There is currently a lack of easy-to-use tools for assessing the severity of cardiogenic shock (CS) patients. This study aims to develop a nomogram for evaluating severity in CS patients regardless of the underlying cause. Methods and Results: The MIMIC-IV database was used to identify 1923 CS patients admitted to the ICU. A multivariate Cox model was developed in the training cohort (70%) based on LASSO regression results. Factors such as age, systolic blood pressure, arterial oxygen saturation, hemoglobin, serum creatinine, blood glucose, arterial pH, arterial lactate, and norepinephrine use were incorporated into the final model. This model was visualized as a Cardiogenic Shock Survival Nomogram (CSSN) to predict 30-day survival rates. The model's c-statistic was 0.75 (95% CI 0.73-0.77) in the training cohort and 0.73 (95% CI 0.70-0.77) in the validation cohort, demonstrating good predictive accuracy. The AUC of the CSSN for 30-day survival probabilities was 0.76 in the training cohort and 0.73 in the validation cohort. Calibration plots showed strong concordance between predicted and actual survival rates, and decision curve analysis (DCA) affirmed the model's clinical utility. The CSSN outperformed the Cardiogenic Shock Score (CSS) in various metrics, including c-statistic, time-dependent ROC, calibration plots, and DCA (c-statistic: 0.75 versus 0.72; AUC: 0.76 versus 0.73). Sensitivity analyses confirmed the model's robustness across both AMI-CS and non-AMI-CS subgroups. Conclusions: The CSSN was developed to predict 30-day survival rates in CS patients irrespective of the underlying cause, showing good performance and potential clinical utility in managing CS.

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Effects of intra-aortic balloon pump on in-hospital outcomes and 1-year mortality in patients with acute myocardial infarction complicated by cardiogenic shock

Cited by 4 publications

References 33 publications

Efficacy and safety of extracorporeal membrane oxygenation for cardiogenic shock complicating myocardial infarction: a systematic review and meta-analysis

Efficacy and safety of extracorporeal membrane oxygenation for cardiogenic shock complicating myocardial infarction: a systematic review and meta-analysis

A multivariate and retrospective analysis of the impact of intra-aortic balloon counterpulsation in Open-Heart surgery

Development and Validation of a Nomogram for Predicting Survival in Patients With Cardiogenic Shock

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