Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock
<i>Background and Objectives</i>. 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...
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| Format: | Article |
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MDPI AG
2023-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/10/1806 |
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| author | Alberto Somaschini Stefano Cornara Sergio Leonardi Andrea Demarchi Alessandro Mandurino-Mirizzi Federico Fortuni Marco Ferlini Gabriele Crimi Rita Camporotondo Massimiliano Gnecchi Luigi Oltrona Visconti Stefano De Servi Gaetano Maria De Ferrari |
| author_facet | Alberto Somaschini Stefano Cornara Sergio Leonardi Andrea Demarchi Alessandro Mandurino-Mirizzi Federico Fortuni Marco Ferlini Gabriele Crimi Rita Camporotondo Massimiliano Gnecchi Luigi Oltrona Visconti Stefano De Servi Gaetano Maria De Ferrari |
| author_sort | Alberto Somaschini |
| collection | DOAJ |
| description | <i>Background and Objectives</i>. 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. <i>Materials and Methods.</i> We enrolled 2958 consecutive patients undergoing pPCI for STEMI in our department from 2005 to 2018. Propensity score matching and mortality analysis were performed. <i>Results</i>. 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%, <i>p</i> = 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. <i>Conclusions</i>. 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. |
| first_indexed | 2024-03-10T21:04:28Z |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T21:04:28Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-1fc12e2142314f60b0f0c214913171cd2023-11-19T17:17:31ZengMDPI AGMedicina1010-660X1648-91442023-10-015910180610.3390/medicina59101806Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic ShockAlberto Somaschini0Stefano Cornara1Sergio Leonardi2Andrea Demarchi3Alessandro Mandurino-Mirizzi4Federico Fortuni5Marco Ferlini6Gabriele Crimi7Rita Camporotondo8Massimiliano Gnecchi9Luigi Oltrona Visconti10Stefano De Servi11Gaetano Maria De Ferrari12Cardiac Intensive Care Unit, Division of Cardiology, San Paolo Hospital, 17100 Savona, ItalyCardiac Intensive Care Unit, Division of Cardiology, San Paolo Hospital, 17100 Savona, ItalyDepartment of Molecular Medicine, Unit of Cardiology, University of Pavia, 27100 Pavia, ItalyDepartment of Molecular Medicine, Unit of Cardiology, University of Pavia, 27100 Pavia, ItalyDepartment of Molecular Medicine, Unit of Cardiology, University of Pavia, 27100 Pavia, ItalyDepartment of Molecular Medicine, Unit of Cardiology, University of Pavia, 27100 Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyInterventional Cardiology Unit, CardioThoraco Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, 16132 Genova, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyDepartment of Molecular Medicine, Unit of Cardiology, University of Pavia, 27100 Pavia, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyDepartment of Molecular Medicine, Unit of Cardiology, University of Pavia, 27100 Pavia, ItalyDivision of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy<i>Background and Objectives</i>. 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. <i>Materials and Methods.</i> We enrolled 2958 consecutive patients undergoing pPCI for STEMI in our department from 2005 to 2018. Propensity score matching and mortality analysis were performed. <i>Results</i>. 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%, <i>p</i> = 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. <i>Conclusions</i>. 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.https://www.mdpi.com/1648-9144/59/10/1806acute myocardial infarctioncardiogenic shockmechanical circulatory supportIABP |
| spellingShingle | Alberto Somaschini Stefano Cornara Sergio Leonardi Andrea Demarchi Alessandro Mandurino-Mirizzi Federico Fortuni Marco Ferlini Gabriele Crimi Rita Camporotondo Massimiliano Gnecchi Luigi Oltrona Visconti Stefano De Servi Gaetano Maria De Ferrari Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock Medicina acute myocardial infarction cardiogenic shock mechanical circulatory support IABP |
| title | Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock |
| title_full | Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock |
| title_fullStr | Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock |
| title_full_unstemmed | Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock |
| title_short | Beneficial Effects of IABP in Anterior Myocardial Infarction Complicated by Cardiogenic Shock |
| title_sort | beneficial effects of iabp in anterior myocardial infarction complicated by cardiogenic shock |
| topic | acute myocardial infarction cardiogenic shock mechanical circulatory support IABP |
| url | https://www.mdpi.com/1648-9144/59/10/1806 |
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