HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stone, G. W. Articles by Ferguson, J. J. Search for Related Content PubMed PubMed Citation Articles by Stone, G. W. Articles by Ferguson, J. J., III

CLINICAL RESEARCH: ACUTE MYOCARDIAL ISCHEMIA/INFARCTION

Contemporary utilization and outcomes of intra-aortic balloon counterpulsation in acute myocardial infarction

The benchmark registry

Gregg W. Stone, MD, FACC^*,*, E. Magnus Ohman, MD, FACC, Michael F. Miller, PhD, Debra L. Joseph, BSN, Jan T. Christenson, MD, FECTS^||, Marc Cohen, MD, FACC^¶, Philip M. Urban, MD, FACC^#, Ramachandra C. Reddy, MD, FACC^**, Robert J. Freedman, MD, FACC, Karen L. Staman, MS and James J. Ferguson, III, MD, FACC

^* Cardiovascular Research Foundation and Lenox Hill Hospital, New York, New York, USA
University of North Carolina, Chapel Hill, North Carolina, USA
M. F. Miller Statistical Services, Langhorne, Pennsylvania, USA
Datascope Corp., Fairfield, New Jersey, USA
^|| University of Geneva Hospital, Geneva, Switzerland
^¶ Hahnemann University Hospital, Philadelphia, Pennsylvania, USA
^# Hôpital de la Tour, Geneva, Switzerland
^** State University of New York Health Science Center, Brooklyn, New York, USA
St. Francis Cabrini Medical Center, Alexandria, Louisiana, USA
Duke Clinical Research Institute, Durham, North Carolina, USA
Texas Heart Institute, Houston, Texas, USA

Manuscript received April 15, 2002; revised manuscript received September 4, 2002, accepted September 20, 2002.

^* Reprint requests and correspondence: Dr. Gregg W. Stone, Cardiovascular Research Foundation, 55 East 59th Street, 6th Floor, New York, New York 10022, USA.
gstone{at}crf.org

OBJECTIVES: We sought to examine contemporary utilization patterns and clinical outcomes in patients with acute myocardial infarction (AMI) requiring intra-aortic balloon pump (IABP) counterpulsation.

BACKGROUND: Despite increasing experience with and broadened indications for intra-aortic counterpulsation, the current indications, associated complications, and clinical outcomes of IABP use in AMI are unknown.

METHODS: Between June 1996 and August 2001, data were prospectively collected from 22,663 consecutive patients treated with aortic counterpulsation at 250 medical centers worldwide; 5,495 of these patients had AMI.

RESULTS: Placement of an IABP in AMI patients was most frequently indicated for cardiogenic shock (27.3%), hemodynamic support during catheterization and/or angioplasty (27.2%) or prior to high-risk surgery (11.2%), mechanical complications of AMI (11.7%), and refractory post-myocardial infarction unstable angina (10.0%). Balloon insertions were successful in 97.7% of patients. Diagnostic catheterization was performed in 96% of patients, and 83% underwent coronary revascularization before hospital discharge. The in-hospital mortality rate was 20.0% (38.7% in patients with shock) and varied markedly by indication and use of revascularization procedures. Major IABP complications occurred in only 2.7% of patients, despite median use for three days, and early IABP discontinuation was required in only 2.1% of patients.

CONCLUSIONS: With contemporary advances in device technology, insertion technique, and operator experience, IABP counterpulsation may be successfully employed for a wide variety of conditions in the AMI setting, providing significant hemodynamic support with rare major complications in a high-risk patient population.

Abbreviations and Acronyms   AMI   acute myocardial infarction   CABG   coronary artery bypass grafting   IABP   intra-aortic balloon pump   LMCA   left main coronary artery   SHOCK   SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK?

This article has been cited by other articles:

				J. Rivard, A. Vergis, and D. Kassum Case report of visceral ischemia: The "tail" of an intra-aortic balloon pump. J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1167 - 1168. [Full Text] [PDF]

				I. George and M. C. Oz Myocardial Revascularization after Acute Myocardial Infarction Card. Surg. Adult, January 1, 2008; 3(2008): 669 - 696. [Full Text]

				J. T Christenson, J. Sierra, J.-A. Romand, M. Licker, and A. Kalangos Long Intraaortic Balloon Treatment Time Leads to More Vascular Complications Asian Cardiovasc Thorac Ann, October 1, 2007; 15(5): 408 - 412. [Abstract] [Full Text] [PDF]

				J. L. Anderson, C. D. Adams, E. M. Antman, C. R. Bridges, R. M. Califf, D. E. Casey Jr, W. E. Chavey II, F. M. Fesmire, J. S. Hochman, T. N. Levin, et al. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine J. Am. Coll. Cardiol., August 14, 2007; 50(7): e1 - e157. [Full Text] [PDF]

				J. L. Anderson, C. D. Adams, E. M. Antman, C. R. Bridges, R. M. Califf, D. E. Casey Jr, W. E. Chavey II, F. M. Fesmire, J. S. Hochman, T. N. Levin, et al. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine J. Am. Coll. Cardiol., August 14, 2007; 50(7): 652 - 726. [Full Text] [PDF]

				M. Thielmann, M. Neuhauser, A. Marr, U. Herold, M. Kamler, P. Massoudy, and H. Jakob Predictors and Outcomes of Coronary Artery Bypass Grafting in ST Elevation Myocardial Infarction Ann. Thorac. Surg., July 1, 2007; 84(1): 17 - 24. [Abstract] [Full Text] [PDF]

				C. F. Azevedo, L. C. Amado, D. L. Kraitchman, B. L. Gerber, T. Edvardsen, N. F. Osman, C. E. Rochitte, K. C. Wu, and J. A.C. Lima The effect of intra-aortic balloon counterpulsation on left ventricular functional recovery early after acute myocardial infarction: a randomized experimental magnetic resonance imaging study Eur. Heart J., June 2, 2005; 26(12): 1235 - 1241. [Abstract] [Full Text] [PDF]