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Title: Trends in intra-aortic balloon pump use in cardiogenic shock in the post-SHOCK II trial era.
Author: Nan, Tie E.
Dinh, D.
Clark, D.
Ajani, A.
Brennan, A.
Cohen, N.
Dagan, M.
Shaw, J.
Sebastian, M.
Freeman, M.
Oqueli, Ernesto
Reid, C.
Kaye, D.
Stub, D.
Duffy, S.
Issue Date: 2021
Conference Name: 69th CSANZ Annual Scientific Meeting 43rd Annual Scientific Meeting of the International Society for Heart Research ANZET 21
Conference Date: August 4-7
Conference Place: Online
Abstract: Background: Myocardial infarction complicated by cardiogenic shock (MI-CS) has a poor prognosis, even with early revascularisation. Previously, intra-aortic balloon pump (IABP) use was thought to improve outcomes, but the SHOCK-II trial (Intraaortic Balloon Pump in Cardiogenic Shock II) found no survival benefit. Objective: This study determined the trends in IABP use in patients with MI-CS undergoing percutaneous intervention (PCI) over time. Methods: Between 2005 and 2018, patients presenting with MI-CS who underwent PCI at a hospital participating in the Melbourne Interventional Group Registry were included. Results: Of the 1,110 patients identified, IABP was used in 478 (43%). IABP was used more in patients with left main and LAD culprit lesions (62% vs 46%), lower ejection fraction (<35%: 18% vs 11%), and preprocedural inotrope use (81% vs 73%; all p<0.05). IABP use was associated with higher in-patient bleeding (18% vs 13%) and 30-day major adverse cardiovascular and cerebrovascular events (MACCE; 58% vs 51%; both p<0.05). The rate of MI-CS increased over time, but after 2012 there was a decline in IABP use (Figure 1). IABP use was a predictor of 30-day MACCE (odds ratio, 1.6; 95% confidence interval, 1.18–2.29 [p=0.003]). However, IABP was not associated with in-hospital, 30-day, or long-term mortality. Conclusion: Consistent with the SHOCK-II trial, IABP use does not reduce short- or long-term mortality, but in this study was associated with increased short-term adverse events. IABP use is declining but is still used in sicker patients with greater myocardium at risk, given limited alternatives.
Internal ID Number: 01760
Type: Conference
Appears in Collections:Research Output

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