Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock

被引:3
|
作者
Somaschini, Alberto [1 ,2 ]
Cornara, Stefano [1 ,2 ]
Leonardi, Sergio [2 ,3 ]
Demarchi, Andrea [2 ,4 ]
Mandurino-Mirizzi, Alessandro [2 ,5 ]
Fortuni, Federico [2 ]
Ferlini, Marco [3 ]
Crimi, Gabriele [6 ]
Camporotondo, Rita [3 ]
Gnecchi, Massimiliano [2 ,7 ]
Visconti, Luigi [3 ]
De Servi, Stefano [2 ]
De Ferrari, Gaetano Maria [8 ,9 ]
机构
[1] San Paolo Hosp, Div Cardiol, Cardiac Intens Care Unit, I-17100 Savona, Italy
[2] Univ Pavia, Dept Mol Med, Unit Cardiol, I-27100 Pavia, Italy
[3] Fdn IRCCS Policlin San Matteo, Div Cardiol, I-27100 Pavia, Italy
[4] Ente Osped Cantonale, Cardioctr Ticino Inst, CH-6900 Lugano, Switzerland
[5] V Fazzi Hosp, Div Cardiol, I-73100 Lecce, Italy
[6] IRCCS Osped Policlin San Martino, CardioThoraco Vasc Dept DICATOV, Intervent Cardiol Unit, I-16132 Genoa, Italy
[7] Fdn IRCCS Policlin San Matteo, Cardiol Traslaz, I-27100 Pavia, Italy
[8] Citta Salute & Sci Hosp, Cardiovasc & Thorac Dept, Div Cardiol, I-10126 Turin, Italy
[9] Univ Turin, Dept Med Sci, I-10126 Turin, Italy
来源
MEDICINA-LITHUANIA | 2023年 / 59卷 / 10期
关键词
acute myocardial infarction; cardiogenic shock; mechanical circulatory support; IABP; INTRAAORTIC BALLOON PUMP; ST-SEGMENT ELEVATION; CIRCULATORY SUPPORT; COUNTERPULSATION; CORONARY; MANAGEMENT; TRIAL;
D O I
10.3390/medicina59101806
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Objectives. Recent guidelines have downgraded the routine use of the intra-aortic balloon pump (IABP) in patients with cardiogenic shock (CS) due to ST-elevation myocardial infarction (STEMI). Despite this, its use in clinical practice remains high. The aim of this study was to evaluate the prognostic impact of the IABP in patients with STEMI complicated by CS undergoing primary PCI (pPCI), focusing on patients with anterior MI in whom a major benefit has been previously hypothesized. Materials and Methods. We enrolled 2958 consecutive patients undergoing pPCI for STEMI in our department from 2005 to 2018. Propensity score matching and mortality analysis were performed. Results. CS occurred in 246 patients (8.3%); among these patients, 145 (60%) had anterior AMI. In the propensity-matched analysis, the use of the IABP was associated with a lower 30-day mortality (39.3% vs. 60.9%, p = 0.032) in the subgroup of patients with anterior STEMI. Conversely, in the whole group of CS patients and in the subgroup of patients with non-anterior STEMI, IABP use did not have a significant impact on mortality. Conclusions. The use of the IABP in cases of STEMI complicated by CS was found to improve survival in patients with anterior infarction. Prospective studies are needed before abandoning or markedly limiting the use of the IABP in this clinical setting.
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页数:12
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