TY - JOUR
T1 - Use and impact of intra-aortic balloon pump on mortality in patients with acute myocardial infarction complicated by cardiogenic shock
T2 - Results of the Euro Heart Survey on PCI
AU - Zeymer, Uwe
AU - Bauer, Timm
AU - Hamm, Christian
AU - Zahn, Ralf
AU - Weidinger, Franz
AU - Seabra-Gomes, Ricardo
AU - Hochadel, Matthias
AU - Marco, Jean
AU - Gitt, Anselm
AU - Eberli, Franz
AU - Serruys, Patrick W.
AU - Silber, Sigmund
AU - Vahanian, Alec
AU - Wijns, William
PY - 2011/8
Y1 - 2011/8
N2 - Aims: The intra-aortic balloon pump (IABP) is recommended by current guidelines as adjunct in patients with cardiogenic shock, despite the lack of larger clinical trials. We sought to investigate the use and impact on mortality of IABP in current practice of percutaneous coronary interventions in Europe. Methods and results: Between May 2005 and April 2008 a total of 47,407 consecutive patients undergoing percutaneous coronary intervention (PCI) in 176 centres in 33 countries in Europe and the Mediterranean basin were enrolled into the registry. From these, 8,102 had ST-elevation myocardial infarction and 7,999 non-ST elevation myocardial infarction and cardiogenic shock was observed in 7.9% and 2.1%, respectively. Of the 653 patients with cardiogenic shock 25% were treated with an IABP. In-hospital mortality, with and without IABP, was 56.9% and 36.1%. In the multivariate analysis the use of IABP was not associated with an improved survival (odds ratio 1.47; 95% CI 0.97-2.21, p=0.07). Conclusions: In current clinical practice in Europe, IABP is used only in one quarter of patients with cardiogenic shock treated with primary PCI. However, there was no hint of a beneficial effect of IABP on outcome. Therefore, a large randomised clinical trial is urgently needed to define the role of IABP in patients with PCI for shock.
AB - Aims: The intra-aortic balloon pump (IABP) is recommended by current guidelines as adjunct in patients with cardiogenic shock, despite the lack of larger clinical trials. We sought to investigate the use and impact on mortality of IABP in current practice of percutaneous coronary interventions in Europe. Methods and results: Between May 2005 and April 2008 a total of 47,407 consecutive patients undergoing percutaneous coronary intervention (PCI) in 176 centres in 33 countries in Europe and the Mediterranean basin were enrolled into the registry. From these, 8,102 had ST-elevation myocardial infarction and 7,999 non-ST elevation myocardial infarction and cardiogenic shock was observed in 7.9% and 2.1%, respectively. Of the 653 patients with cardiogenic shock 25% were treated with an IABP. In-hospital mortality, with and without IABP, was 56.9% and 36.1%. In the multivariate analysis the use of IABP was not associated with an improved survival (odds ratio 1.47; 95% CI 0.97-2.21, p=0.07). Conclusions: In current clinical practice in Europe, IABP is used only in one quarter of patients with cardiogenic shock treated with primary PCI. However, there was no hint of a beneficial effect of IABP on outcome. Therefore, a large randomised clinical trial is urgently needed to define the role of IABP in patients with PCI for shock.
KW - Cardiogenic shock
KW - Hospital mortality
KW - Intra-aortic balloon pump
KW - Percutaneous coronary intervention
UR - https://www.scopus.com/pages/publications/80355141656
U2 - 10.4244/EIJV7I4A72
DO - 10.4244/EIJV7I4A72
M3 - Article
C2 - 21764661
AN - SCOPUS:80355141656
SN - 1774-024X
VL - 7
SP - 437
EP - 441
JO - EuroIntervention
JF - EuroIntervention
IS - 4
ER -
