A total of 300 patients in the IABP group and 298 in the control group were included in the analysis of the primary end point. At 30 days, 119 patients in the IABP group (39.7%) and 123 patients in the control group (41.3%) had died (relative risk with IABP, 0.96; 95% confidence interval, 0.79 to 1.17; P = 0.69). There were no significant differences in secondary end points or in process-of-care measures, including the time to hemodynamic stabilization, the length of stay in the intensive care unit, serum lactate levels, the dose and duration of catecholamine therapy, and renal function. The IABP group and the control group did not differ significantly with respect to the rates of major bleeding (3.3% and 4.4%, respectively; P = 0.51), peripheral ischemic complications (4.3% and 3.4%, P = 0.53), sepsis (15.7% and 20.5%, P = 0.15), and stroke (0.7% and 1.7%, P = 0.28). Conclusions The use of intraaortic balloon counterpulsation did not significantly reduce 30-day mortality in patients with cardiogenic shock complicating acute myocardial infarction for whom an early revascularization strategy was planned. (Funded by the German Research Foundation and others; IABP-SHOCK II ClinicalTrials.gov number, NCT00491036.)

/pdf/intraaortic-balloon-support-for-myocardial-infarction-with-9dc8rp3jog.pdf

Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock

1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction)

http://www.mmh.org.tw/taitam/car_int/Documents/amipdf99edits.pdf

ACC/AHA Guidelines for the Management of Patients With Acute Myocardial Infarction

Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities.

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)61783-3.pdf

Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial

Eighty-seven patients with cardiogenic shock were treated with the intra-aortic counterpulsating balloon in 10 institutions according to a common protocol. Clinical and physiologic respons...

https://www.nejm.org/doi/pdf/10.1056/NEJM197305102881901?listPDF=true

Peter Fleming

Papers

Intra-aortic balloon counterpulsation in cardiogenic shock. Report of a co-operative clinical trial.