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Role of Intra-Aortic Balloon Pump Counterpulsation in the Treatment of Acute Myocardial Infarction Complicated by Cardiogenic Shock: Evidence from the Portuguese Nationwide Registry

2016-11Journal article Open access
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dc.contributor.authorTimóteo, AT
dc.contributor.authorNogueira, M
dc.contributor.authorAguiar Rosa, S
dc.contributor.authorBelo, A
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2019-11-11T16:26:21Z
dc.date.available2019-11-11T16:26:21Z
dc.date.issued2016-11
dc.description.abstractBACKGROUND: In previous guidelines, intra-aortic balloon pump (IABP) use was strongly recommended in the treatment of cardiogenic shock in the context of acute myocardial infarction. The recent IABP-SHOCK II trial demonstrated no benefit in short- and medium-term mortality with the use of IABP. It was our objective to evaluate in a real life nationwide population of patients with acute myocardial infarction the impact of IABP in short- and medium-term mortality. METHODS: We included patients admitted with acute myocardial infarction in Killip class IV in the first 24 hours, all submitted to urgent coronary angiography. Our study objective was the occurrence of hospital and six-month all-cause mortality. RESULTS: From the 33,300 patients included in the registry, 4.2% presented with Killip class IV in the first 24 hours and 646 (43.6%) were submitted to urgent coronary angiography. IABP was implanted in 19.8% of these patients. The IABP group was younger, had higher admission heart rate, more multivessel disease and more left main disease. There were 260 hospital deaths (40.2%), similar between groups (46.1% vs. 38.8%, p=0.132). IABP use was associated with a deleterious effect in patients with previous MI and beneficial effect in patients with mechanical complications. IABP use had a neutral effect on mortality (hazard ratio 1.14, 95% confidence interval 0.84-1.56). This was further confirmed in a propensity score matching analysis. CONCLUSIONS: In a real life population of patients with acute myocardial infarction, the use of IABP for the treatment of cardiogenic shock was associated with a neutral effect.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur Heart J Acute Cardiovasc Care. 2016 Nov;5(7):23-31.pt_PT
dc.identifier.doi10.1177/2048872615606600pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3350
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Publicationspt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectIntra-Aortic Balloon Pumpingpt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMyocardial Infarctionpt_PT
dc.subjectPortugalpt_PT
dc.subjectPropensity Scorept_PT
dc.subjectRegistriespt_PT
dc.subjectShock, Cardiogenicpt_PT
dc.subjectHSM CARpt_PT
dc.titleRole of Intra-Aortic Balloon Pump Counterpulsation in the Treatment of Acute Myocardial Infarction Complicated by Cardiogenic Shock: Evidence from the Portuguese Nationwide Registrypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage31pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage23pt_PT
oaire.citation.titleEuropean Heart Journal: Acute Cardiovascular Carept_PT
oaire.citation.volume5pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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