Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock

Unverzagt, Susanne; Prondzinsky, Roland; Buerke, Michael; Werdan, Karl; Haerting, Johannes; Thiele, Holger

doi:10.1002/14651858.cd007398

Cited by 7 publications

(7 citation statements)

References 34 publications

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“…22 Ventricular assist devices provide greater hemodynamic benefit than balloon counterpulsation but are associated with a higher rate of adverse events and no proven survival benefit. 5,21,23 On the basis of existing data, current guidelines do not recommend ventricular assist devices as first-line therapy for patients with acute myocardial infarction and cardiogenic shock. 8 Our trial had a number of limitations.…”

Section: Discussionmentioning

confidence: 99%

Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock

et al. 2012

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“…Mortality was captured throughout the pathway. Event probabilities for all treatment arms were based on clinical expert opinion, the published literature, and data from the Bordeaux University Hospital (Table 1) [11,12,20,[22][23][24]. The modeled care pathway was designed in line with guidance from the six previously described clinical experts working within the French healthcare system to accurately represent current clinical practice in France.…”

Section: Modeling Approachmentioning

confidence: 99%

“…The most widely used temporary MCS approaches over the past few decades include the intra-aortic balloon pump (IABP) and venoarterial extracorporeal membrane oxygenation (VA-ECMO), but the ongoing, high levels of mortality in patients with CS indicate a need for more effective interventions [10]. For example, intervention with IABP has been shown to not significantly reduce 30-day mortality in patients with CS following acute MI [11,12]. Indeed, IABP has been withdrawn from the European treatment guidelines following the results of the IABP-SHOCK II trial [1,11].…”

Section: Introductionmentioning

confidence: 99%

Budget Impact Analysis of Impella CP® Utilization in the Management of Cardiogenic Shock in France: A Health Economic Analysis

et al. 2022

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Introduction: Early detection and treatment of cardiogenic shock (CS) is crucial to avoid irreparable multiorgan damage and mortality. Impella CP Ò is a novel temporary mechanical circulatory support (MCS) device associated with greater hemodynamic support and significantly fewer device-related complications compared with other MCS devices, e.g., intra-aortic balloon pumps (IABP) and venoarterial extracorporeal membrane oxygenation (VA-ECMO). The present study evaluated the budget impact of introducing Impella CP versus IABP and VA-ECMO in patients with CS following an acute myocardial infarction (MI) in France. Methods: A budget impact model was developed to compare the cost of introducing Impella CP with continuing IABP and VA-ECMO treatment from a Mandatory Health Insurance (MHI) perspective in France over a 5-year time horizon, with 700 patients with refractory CS assumed to be eligible for treatment per year. Costs associated with Impella CP and device-related complications for all interventions were captured and clinical input data were based on published sources. Scenario analyses were performed around key parameters. Results: Introducing Impella CP was associated with cumulative cost savings of EUR 2.7 million over 5 years, versus continuing current clinical practice with IABP and VA-ECMO. Cost savings were achieved in every year of the analysis and driven by the lower incidence of device-related complications with Impella CP, with estimated 5-year cost savings of EUR 22.4 million due to avoidance of complications. Total cost savings of more than EUR 250,000 were projected in the first year of the analysis, which increased as the market share of Impella CP was increased. Scenario analyses indicated that the findings of the analysis were robust. Conclusion: Treatment with Impella CP in adult patients aged less than 75 years in a state of refractory CS following an MI was projected to lead to substantial cost savings from an MHI

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“…The Cochrane Database systematic review [11], that included 8 randomised control trials (105 patients with IABP) demonstrated no survival benefit for IABP when used in patients with CS and AMI. In contrast, Bahekar et al [12] analysed 6 cohorts containing 24,541 patients with IABP and reported a 28 % (p<0.0004) reduction in mortality in those receiving IABP.…”

Section: Ami With Csmentioning

confidence: 99%

Use of Left Ventricular Support Devices During Acute Coronary Syndrome and Percutaneous Coronary Intervention

Spiro

Doshi

2014

Curr Cardiol Rep

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In an effort to improve outcomes in percutaneous coronary intervention (PCI), percutaneous ventricular assist devices (PVADs) have been investigated in (1) high-risk PCI, (2) acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) and (3) in AMI without CS. PCI has become an increasing complex due to an ageing population with complex disease and the frequent presence of impaired LV function. Patients undergoing high-risk PCI in these circumstances are prone to acute cardiovascular collapse. Additionally, mortality in AMI complicated by CS remains high. Lastly, LV support during AMI may reduce infarct size and therefore preserve LV function. At present, four commercially available devices exist: intra-aortic balloon pump counterpulsation (IABP), Impella, TandemHeart and extracorporeal membrane oxygenation (ECMO). These devices are employed in an effort to increase cardiac output, mean arterial pressure (MAP) and coronary perfusion and to reduce pulmonary capillary wedge pressure (PCWP). The mechanism of action differs with each device, and there are advantages and disadvantages. In this update, we discuss recent data describing the use of PVADs to support patients with AMI with or without cardiogenic shock and during high-risk PCI. We focus on the unique features of each device, highlighting strengths, weaknesses and frequently encountered complications, which may be important when tailoring the most appropriate PVAD therapy to an individual patient's need.

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Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock

Abstract: Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock.

Cited by 7 publications

References 34 publications

Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock

Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock

Budget Impact Analysis of Impella CP® Utilization in the Management of Cardiogenic Shock in France: A Health Economic Analysis

Use of Left Ventricular Support Devices During Acute Coronary Syndrome and Percutaneous Coronary Intervention

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