Use of aortic counterpulsation to improve sustained coronary artery patency during acute myocardial infarction. Results of a randomized trial. The Randomized IABP Study Group.

Ohman, E. Magnus; George, Barry S.; White, C J; Kern, M J; Gurbel, Paul A.; Freedman, Robert J.; Lundergan, Conor F.; Hartmann, Joseph R.; Talley, J. David; Frey, Markus

doi:10.1161/01.cir.90.2.792

Cited by 230 publications

(120 citation statements)

References 32 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…Reports have described the shortening of decision time by means of early recognition of symptoms by education of patients, 5 the 'chain of survival' concept advocated by the American Heart Association, 6 thrombolytic therapy, 7-13 anticoagulant therapy, 7,8,14,15 emergency PTCA, 13,[16][17][18][19][20][21][22][23] assisted circulation 24,25 and a system to determine the effect of prehospital-initiated treatment of myocardial infarction. 26,27 Many reports have shown that case-fatality rates of AMI patients arriving quickly at specialty institutions are decreased by recanalization therapy and assisted circulation in contrast to patients not so treated.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Treatment of Acute Myocardial Infarction Using Ambulance Records in Japanese Cities

et al. 1999

View full text Add to dashboard Cite

he usefulness of recanalization therapy that includes thrombolytic therapy and emergency percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction (AMI) is recognized, 1 and this procedure is widely performed as a primary treatment. Decreases in the case-fatality rates from AMI from approximately 30% to 10% have been reported with this therapy. However, many more institutions that specialize in cardiology and offer these procedures are needed. Average rates of fatality within 28 days after AMI were 48% for males and 54% for females according to the multinational monitoring of trends and determinants in cardiovascular disease (MONICA) project (21 countries; age 35-64 years). 2 In spite of the usefulness of recanalization therapy, it has not been available for all eligible AMI patients worldwide. In the US, thrombolysis is considered the first line of therapy for AMI in suitable patients, but in a recent report it was used in only 70% of ideal candidates. 3 In Japan, the mortality rate for AMI is low compared with that in the US or European countries, and there is a concentration of specialty institutions in urban districts at which patients can conveniently receive emergency PTCA or percutaneous transluminal coronary recanalization (PTCR) treatment.Although many reports describe results of medical treatment at specific institutions, there have been few investigations to determine the actual treatment situation for patients in an entire area. In order to determine treatment strategies for AMI, we studied the ambulance records from Chiba City and Ichihara City, Japan. We perused the medical records of the admitting institutions for all patients arriving by ambulance with a diagnosis of AMI, reconfirmed the diagnoses, and ascertained the medical treatment given in the acute phase. We also determined the availability of equipment and personnel for cardiac care in the admitting institutions and the case-fatality rates. Based on this information, recommendations are made. Methods Study PopulationFrom all 1992 ambulance records (n=31,191) from the Fire Departments in Chiba City and Ichihara City, Chiba Prefecture, Japan, we determined that 401 patients were admitted to hospital for AMI. Thirteen patients were excluded because they were seen more than 2 weeks after the onset of symptoms. Of the remaining 388 patients admitted within 2 weeks after the onset of symptoms, we examined the medical records of the institutions to which the patients were finally admitted and treated, reconfirmed the diagnoses using MONICA criteria 4 and determined what medical treatments were given. Briefly, the criteria for definite AMI were: (1) definite ECG changes; (2) probable ECG changes and abnormal enzymes; (3) typical symptoms and abnormal enzymes; or (4) fatal case with the appearance of fresh myocardial infarction and/or recent coronary occlusion found at necropsy. There were 171 patients who fulfillled the criteria, which included 168 patients admitted alive (Fig 1). Because observation periods were differ...

show abstract

Section: Discussionmentioning

confidence: 99%

Analysis of the Treatment of Acute Myocardial Infarction Using Ambulance Records in Japanese Cities

et al. 1999

View full text Add to dashboard Cite

show abstract

“…Just prior to systole, the IABP deflates creating a vacuum effect that promotes forward flow to the aorta and its branches. Indications for the IABP include cardiogenic shock, 45,46 unstable angina, 47,48 acute infarction or recurrent ischaemia, 49 refractory ventricular tachycardia 50 and as a bridge to transplantation. 51 In a large study of 17,540 IABP insertions, the major complication rate (severe bleeding, major limb ischaemia, balloon leak or in-hospital mortality related to IABP) was 2.6%.…”

Section: 12mentioning

confidence: 99%

Radiology of cardiac devices and their complications

DiPoce

Bernheim²,

Spindola‐Franco³

2015

BJR

View full text Add to dashboard Cite

This article familiarizes the reader with several different cardiac devices including pacemakers and implantable cardioverter defibrillators, intra-aortic balloon pumps, ventricular assist devices, valve replacements and repairs, shuntoccluding devices and passive constraint devices. Many cardiac devices are routinely encountered in clinical practice. Other devices are in the early stages of development, but circumstances suggest that they too will become commonly found. The radiologist must be familiar with these devices and their complications.

show abstract

“…In spite of the variety of definitions, IABP insertion in such high-risk patients in the absence of CS has repeatedly shown to be of no benefit. 16,[39][40][41] In the pre-PCI era, a study by Ohman et al 41 compared the use of balloon pump compared with standard therapy and found a lower rate of reocclusion and adverse clinical event rate in the balloon pump group. The Primary Angioplasty in Myocardial Infarction-II trial demonstrated no benefit of balloon pump use over standard treatment on the clinical end points of all-cause mortality or adverse cardiovascular events, including stroke, reinfarction, and Killip class) in 437 patients who underwent primary PCI in the prestenting era.…”

Section: Post-mi Without Cardiogenic Shockmentioning

confidence: 99%

Intra-Aortic Balloon Pump for High-Risk Percutaneous Coronary Intervention

Patterson

Perera

Redwood

2014

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

Interestingly, the International Benchmark Registry (250 US and non-US centers) of over 20 000 patients treated with IABP suggested that 1 in 5 cases of IABP implantation were for CS and 1 in 5 as an adjunct to high-risk PCI. 11 In the context of AMI, IABP was used more frequently during CS (30%) or an adjunct to PCI (30%).10 Analysis of the CathPCI Registry from the National Cardiovascular Data Registry of patients who underwent high-risk PCI (10% in CS and 80% ST-segmentelevation myocardial infarction [STEMI]) with and without the use of IABP found IABP use was slightly less-10% of (Circ Cardiovasc Interv. 2014;7:712-720.) © 2014 American Heart Association, Inc. Post-MI and Cardiogenic ShockAMI is complicated by CS in ≈5% to 10% of cases. Although death from AMI has decreased with aggressive primary prevention and after wide-scale institution of early urgent revascularization, the incidence of CS after MI remains unchanged. 25The presence of CS is a major adverse prognostic factor and still the most common cause of hospital mortality (60%-70%) associated with AMI. 26 In addition to revascularization, optimal drug therapy, vasopressor, and inotropic support, IABP is the most commonly used mechanical support device to maintain hemodynamic stability in an attempt to improve clinical outcome. The evidence for the use of IABP as an adjunct to PCI in post-MI CS is controversial. A recent meta-analysis of registry data showed no benefit from the use of IABP in CS with regard to 30-day mortality independent of reperfusion strategy, which led to the recent downgrading of the American Heart Association guidelines on hemodynamic support in post-MI CS from a Class I recommendation to Class IIB. [27][28][29] Early use of IABP in post-MI CS was based predominantly on small nonrandomized retrospective studies. In the thrombolytic era, concomitant IABP in the presence of recombinant-tissue plasminogen activator was thought to enhance thrombolysis through augmentation of perfusion pressure and was associated with a reduction in in-hospital and 1-year mortality when compared with thrombolysis alone. 30,31 In the late 1990s, the multicenter randomized Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial showed a benefit to short-, medium-, and longterm survival incurred by early revascularization post-MI complicated by CS. 32 The Thrombolysis and Counterpulsation to Improve Survival in Myocardial Infarction Complicated by Hypotension and Suspected Cardiogenic Shock (TACTICS) randomized trial of IABP-assisted thrombolysis in post-MI CS did not reach its primary end point of improved 6-month survival, but there was trend to increased survival with IABP in patients with significant heart failure. 33 One interpretation is that thrombolysis is an inferior reperfusion strategy, and this may explain why no benefit has been definitively shown with IABP after primary PCI. A meta-analysis of IABP use in patients with AMI showed no effect on outcome; however, in the subset of AMI and CS, there was si...

show abstract

Use of aortic counterpulsation to improve sustained coronary artery patency during acute myocardial infarction. Results of a randomized trial. The Randomized IABP Study Group.

Abstract: This randomized trial showed that careful use of prophylactic aortic counterpulsation can prevent reocclusion of the infarct-related artery and improve overall clinical outcome in patients undergoing acute cardiac catheterization during myocardial infarction.

Cited by 230 publications

References 32 publications

Analysis of the Treatment of Acute Myocardial Infarction Using Ambulance Records in Japanese Cities

Analysis of the Treatment of Acute Myocardial Infarction Using Ambulance Records in Japanese Cities

Radiology of cardiac devices and their complications

Intra-Aortic Balloon Pump for High-Risk Percutaneous Coronary Intervention

Contact Info

Product

Resources

About