Encouraging survival rates in patients with acute myocardial infarction treated with an intra-aortic balloon pump
To evaluate a 30-day and long-term outcome of patients with acute myocardial infarction (AMI) treated with intra-aortic balloon pump (IABP) counterpulsation and to identify predictors of a 30-day and long-term all-cause mortality.
Retrospective cohort study of 437 consecutive AMI patients treated with IABP between January 1990 and June 2004. A Cox proportional hazards model was used to identify predictors of a 30-day and long-term all-cause mortality.
Mean age of the study population was 61 ± 11 years, 80% of the patients were male, and 68% had cardiogenic shock. Survival until IABP removal after successful haemodynamic stabilisation was 78% (n = 341). Cumulative 30-day survival was 68%. Median follow-up was 2.9 years (range, 6 months to 15 years). In patients who survived until IABP removal, cumulative 1-, 5-, and 10-year survival was 75%, 61%, and 39%, respectively. Independent predictors of higher long-term mortality were prior cerebrovascular accident (hazard ratio (HR), 1.8; 95% confidence interval (CI), 1.0–3.4), need for antiarrhythmic drugs (HR, 2.3; 95% CI, 1.5–3.3), and need for renal replacement therapy (HR, 2.3; 95% CI, 1.2–4.3). Independent predictors of lower long-term mortality were primary percutaneous coronary intervention (PCI; HR, 0.6; 95% CI, 0.4–1.0), failed thrombolysis with rescue PCI (HR, 0.5; 95% CI, 0.3–0.9), and coronary artery bypass grafting (HR, 0.3; 95% CI, 0.1–0.5).
Despite high in-hospital mortality in patients with AMI treated with IABP, a favourable number of patients survived in the long-term. These results underscore the value of aggressive haemodynamic support of patients throughout the acute phase of AMI.
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- Encouraging survival rates in patients with acute myocardial infarction treated with an intra-aortic balloon pump
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Netherlands Heart Journal
Volume 19, Issue 3 , pp 112-118
- Cover Date
- Print ISSN
- Online ISSN
- Bohn Stafleu van Loghum
- Additional Links
- Acute myocardial infarction
- Intra-aortic balloon pump
- Author Affiliations
- 1. Department of Cardiology, Thorax Center, Erasmus MC, Room Ba 577,’s Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands
- 2. Department of Intensive Care Medicine, Academic Medical Center, Amsterdam, the Netherlands
- 3. Department of Cardiology, Maasstad Hospital, location Zuider, Rotterdam, the Netherlands