Intraaortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock: Design and rationale of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial

Thiele, Holger; Schuler, Gerhard; Neumann, Franz‐Josef; Hausleiter, Jörg; Olbrich, Hans-Georg; Schwarz, Bettina; Hennersdorf, Marcus; Empen, Klaus; Fuernau, Georg; Desch, Steffen; Waha, Suzanne de; Eitel, Ingo; Hambrecht, Rainer; Böhm, Michael; Kurowski, Volkhard; Lauer, Bernward; Minden, H; Figulla, Hans‐Reiner; Braun-Dullaeus, Ruediger C.; Strasser, Ruth H.; Rochor, Kristin; Maier, Sebastian; Möllmann, Helge; Schneider, Steffen; Ebelt, Henning; Werdan, Karl; Zeymer, Uwe

doi:10.1016/j.ahj.2012.03.012

Cited by 136 publications

(37 citation statements)

References 29 publications

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“…In a recent multicenter IABP trial, access site complications requiring interventions were encountered significantly less frequently (4.3%); bleedings however were also common (severe 3.3%, moderate 17.3%) [9]. A single-center study of ECLS in cardiogenic shock reported bleeding complications in 17.4% and need for surgical intervention in 8.7% of all patients [23] while registry data for ECLS in cardiopulmonary resuscitation report complications directly related to ECLS implantation in every third patient [16].…”

Section: Discussionmentioning

confidence: 99%

Unprotected Left Main Percutaneous Coronary Intervention in Acute Coronary Syndromes with Extracorporeal Life Support Backup

et al. 2015

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Background. Left main PCI is superior to coronary bypass surgery in selected patients. Registry data, however, suggest significant early adverse event rates associated with unprotected left main PCI. We aimed to evaluate safety of an extracorporeal life support (ECLS) as backup system during PCI. Methods. We report a registry study of 16 high-risk patients presenting with acute coronary syndromes undergoing unprotected left main PCI with an ECLS backup. Results. Seven patients (43.8%) presented with an acute myocardial infarction while 9 patients (56.3%) had unstable angina. Unprotected left main PCI could be successfully performed in all 16 patients. Mortality or thromboembolic event rates were zero within the index hospital stay. General anesthesia was necessary only in 5 patients (31.3%). Access site bleeding requiring transfusion was encountered in 4 patients (25.0%). Three patients (18.8%) developed access site complications requiring surgical intervention. All patients were ECLS-free after 96 hours. Conclusions. Unprotected left main PCI could be safely and effectively performed after ECLS implantation as backup in acute coronary syndromes in our patient collectively. Vascular access site complications however need to be considered when applying ECLS as backup system.

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Section: Discussionmentioning

confidence: 99%

Unprotected Left Main Percutaneous Coronary Intervention in Acute Coronary Syndromes with Extracorporeal Life Support Backup

et al. 2015

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“…In 2012, the IABP-SHOCK II study reported no benefit with IABP therapy in patients with AMI-CS. No large, randomized studies have evaluated the utility of IABP therapy in HF-CS 17 .…”

Section: Solving the Hemodynamic Support Equation With Acute Mechanicmentioning

confidence: 99%

Acute mechanical circulatory support for cardiogenic shock: the “door to support” time

Esposito

Kapur

2017

F1000Res

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Cardiogenic shock (CS) remains a major cause of in-hospital mortality in the setting of acute myocardial infarction. CS begins as a hemodynamic problem with impaired cardiac output leading to reduced systemic perfusion, increased residual volume within the left and right ventricles, and increased cardiac filling pressures. A critical step towards the development of future algorithms is a clear understanding of the treatment objectives for CS. In this review, we introduce the “door to support” time as an emerging target of therapy to improve outcomes associated with CS, define four key treatment objectives in the management of CS, discuss the importance of early hemodynamic assessment and appropriate selection of acute mechanical circulatory support (AMCS) devices for CS, and introduce a classification scheme that identifies subtypes of CS based on cardiac filling pressures.

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“…Multiple trials have shown that intra-aortic balloon pump (IABP) counterpulsation provides insufficient support in AMICS to improve survival and therefore many clinicians have opted to use more robust MCS devices such as Impella (Abiomed, Danvers, MA), Tandem Heart (Cardiac Assist Inc, Pittsburgh, PA), and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). [3][4][5][6] In 2016, the Food and Drug Administration (FDA) approved Impella, a percutaneous microaxial MCS device, for use in patients with cardiogenic shock. The basis of Impella's FDA approval and increasing use in the United States has been significant improvements in hemodynamics when compared with IABP.…”

Section: Introductionmentioning

confidence: 99%

Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative

Basir¹,

Kapur²,

Patel³

et al. 2019

Cathet Cardio Intervent

370

311

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Background The National Cardiogenic Shock Initiative is a single‐arm, prospective, multicenter study to assess outcomes associated with early mechanical circulatory support (MCS) in patients presenting with acute myocardial infarction and cardiogenic shock (AMICS) treated with percutaneous coronary intervention (PCI). Methods Between July 2016 and February 2019, 35 sites participated and enrolled into the study. All centers agreed to treat patients with AMICS using a standard protocol emphasizing invasive hemodynamic monitoring and rapid initiation of MCS. Inclusion and exclusion criteria mimicked those of the “SHOCK” trial with an additional exclusion criteria of intra‐aortic balloon pump counter‐pulsation prior to MCS. Results A total of 171 consecutive patients were enrolled. Patients had an average age of 63 years, 77% were male, and 68% were admitted with AMICS. About 83% of patients were on vasopressors or inotropes, 20% had a witnessed out of hospital cardiac arrest, 29% had in‐hospital cardiac arrest, and 10% were under active cardiopulmonary resuscitation during MCS implantation. In accordance with the protocol, 74% of patients had MCS implanted prior to PCI. Right heart catheterization was performed in 92%. About 78% of patients presented with ST‐elevation myocardial infarction with average door to support times of 85 ± 63 min and door to balloon times of 87 ± 58 min. Survival to discharge was 72%. Creatinine ≥2, lactate >4, cardiac power output (CPO) <0.6 W, and age ≥ 70 years were predictors of mortality. Lactate and CPO measurements at 12–24 hr reliably predicted overall mortality postindex procedure. Conclusion In contemporary practice, use of a shock protocol emphasizing best practices is associated with improved outcomes.

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Intraaortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock: Design and rationale of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial

Cited by 136 publications

References 29 publications

Unprotected Left Main Percutaneous Coronary Intervention in Acute Coronary Syndromes with Extracorporeal Life Support Backup

Unprotected Left Main Percutaneous Coronary Intervention in Acute Coronary Syndromes with Extracorporeal Life Support Backup

Acute mechanical circulatory support for cardiogenic shock: the “door to support” time

Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative

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