Trends in Intra-Aortic Balloon Pump Use in Cardiogenic Shock After the SHOCK-II Trial

Tie, Emilia Nan; Dinh, D.; Chan, William; Clark, David; Ajani, A.; Brennan, A.; Dagan, M.; Cohen, Naomi; Oqueli, Ernesto; Freeman, Melanie; Hiew, C.; Shaw, James A.; Reid, C.; Kaye, D.; Duffy, Stephen J.

doi:10.1016/j.amjcard.2022.12.019

Cited by 8 publications

(3 citation statements)

References 23 publications

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“…Finally, recent guidelines for the use of IABP in CS do not recommend it anymore; however, IABP is still used as a last-resort treatment for patients in severe CS to increase myocardial perfusion. [43] In conclusion, this study demonstrated that patients with MI in CS treated with ECMO, in addition to IABP support, have comparable overall 30-day and 1-year risks of mortality compared to those not managed with ECMO. However, it appears that survivors after short-term ECMO support may have a better clinical outcome which should be considered hypothesis-generating.…”

Section: Discussionmentioning

confidence: 51%

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Adjusted mortality of extracorporeal membrane oxygenation for acute myocardial infarction patients in cardiogenic shock

et al. 2023

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Cardiogenic shock (CS) is a common cause of death following acute myocardial infarction (MI). This study aimed to evaluate the adjusted mortality of venoarterial extracorporeal membrane oxygenation (VA-ECMO) with intra-aortic balloon counterpulsation (IABP) for patients with MI-CS. We included 300 MI patients selected from a multinational registry and categorized into VA-ECMO + IABP (N = 39) and no VA-ECMO (medical management ± IABP) (N = 261) groups. Both groups’ 30-day and 1-year mortality were compared using the weighted Kaplan–Meier, propensity score, and inverse probability of treatment weighting methods. Adjusted incidences of 30-day (VA-ECMO + IABP vs No VA-ECMO, 77.7% vs 50.7; P = .083) and 1-year mortality (92.3% vs 84.8%; P = .223) along with propensity-adjusted and inverse probability of treatment weighting models in 30-day (hazard ratio [HR], 1.57; 95% confidence interval [CI], 0.92–2.77; P = .346 and HR, 1.44; 95% CI, 0.42–3.17; P = .452, respectively) and 1-year mortality (HR, 1.56; 95% CI, 0.95–2.56; P = .076 and HR, 1.33; 95% CI, 0.57–3.06; P = .51, respectively) did not differ between the groups. However, better survival benefit 30 days post-ECMO could be supposed (31.6% vs 83.4%; P = .022). Therefore, patients with MI-CS treated with IABP with additional VA-ECMO and those not supported with ECMO have comparable overall 30-day and 1-year mortality risks. However, VA-ECMO-supported survivors might have better long-term clinical outcomes.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Adjusted mortality of extracorporeal membrane oxygenation for acute myocardial infarction patients in cardiogenic shock

et al. 2023

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“…Indeed, however, the application of IABP in cardiogenic shock was significantly influenced by the results of IABP-SHOCK. Based on IABP-SHOCK, the use of IABP has decreased dramatically since 2012, despite increasing rates of infarct-related cardiogenic shock [ 19 ]. Despite several pathophysiological studies suggesting a hemodynamic gain under IABP for cardiogenic shock [ 20 , 21 ], only one randomized trial, IABP-SHOCK, indicates no improvement was observed in measured hemodynamic parameters [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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,

Yu,

et al. 2023

BMC Cardiovasc Disord

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Background The role of intra-aortic balloon counterpulsation (IABP) in cardiogenic shock complicating acute myocardial infarction (AMI) is still a subject of intense debate. In this study, we aim to investigate the effect of IABP on the clinical outcomes of patients with AMI complicated by cardiogenic shock undergoing percutaneous coronary intervention (PCI). Methods From the Medical Information Mart for Intensive Care (MIMIC)-IV 2.2, 6017 AMI patients were subtracted, and 250 patients with AMI complicated by cardiogenic shock undergoing PCI were analyzed. In-hospital outcomes (death, 24-hour urine volumes, length of ICU stays, and length of hospital stays) and 1-year mortality were compared between IABP and control during the hospital course and 12-month follow-up. Results An IABP was implanted in 30.8% (77/250) of patients with infarct-related cardiogenic shock undergoing PCI. IABP patients had higher levels of Troponin T (3.94 [0.73–11.85] ng/ml vs. 1.99 [0.55–5.75] ng/ml, p-value = 0.02). IABP patients have a longer length of ICU and hospital stays (124 [63–212] hours vs. 83 [43–163] hours, p-value = 0.005; 250 [128–435] hours vs. 170 [86–294] hours, p-value = 0.009). IABP use was not associated with lower in-hospital mortality (33.8% vs. 33.0%, p-value = 0.90) and increased 24-hour urine volumes (2100 [1455–3208] ml vs. 1915 [1110–2815] ml, p-value = 0.25). In addition, 1-year mortality was not different between the IABP and the control group (48.1% vs. 48.0%; hazard ratio 1.04, 95% CI 0.70–1.54, p-value = 0.851). Conclusion IABP may be associated with longer ICU and hospital stays but not better short-and long-term clinical prognosis.

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ARGEN SHOCK: Mortality related to the use of Swan Ganz and to the hemodynamic pattern found in patients with AMICS

Costa,

Delfino,

Mauro

et al. 2024

Current Problems in Cardiology

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Trends in Intra-Aortic Balloon Pump Use in Cardiogenic Shock After the SHOCK-II Trial

Cited by 8 publications

References 23 publications

Adjusted mortality of extracorporeal membrane oxygenation for acute myocardial infarction patients in cardiogenic shock

Adjusted mortality of extracorporeal membrane oxygenation for acute myocardial infarction patients in cardiogenic shock

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

ARGEN SHOCK: Mortality related to the use of Swan Ganz and to the hemodynamic pattern found in patients with AMICS

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