Use of intra-aortic balloon pump in patients with acute coronary syndrome and cardiogenic shock at the University Hospital Centre Osijek, in the period from 2014 to 2015

    Authors

    Keywords

    intra-aortic balon pump, shock, acute coromary syndrome

    DOI

    https://doi.org/10.15836/ccar2016.101

    Full Text

    There are conflicting evidence regarding the use of intra-aortic balon pump (IABP) in acute coronary syndrome and shock patients. (1, 2) Current European Society of Cardiology (ESC) Guidelines does not recommend IABP to be routinely used. It is intended to be used in patients with non ST-segment elevation myocardial infarction (NSTEMI) with acute mechanical complications. ESC Guidelines considered meta-analyses by Sjauw el al and the major randomized clinical trial IABP SHOCK II. This research did not confirm degraded mortality 30 days after ST-segment elevation myocardial infarction (STEMI) with shock. There are several flaws to this study: the absence of long-term survival, not taking into account patients with mechanical complications of myocardial infarction, NSTEMI patients and cardiogenic shock after 12 hours. 50% of patients had blood pressure ≥ 90 mmHg, which rise the question of inclusion criteria. However, meta-analyses showed significant reduction in mortality in cardiogenic shock after STEMI in patients treated with thrombolysis and IABP, but without primary percutaneous coronary intervention. New randomized clinical trials are needed, so that a definite conclusion on long-term survival could be made, as well to establish if there are groups within those patients, which could benefit from the use of IABP. We present our IABP experience, in University Hospital Centre Osijek, in time period from 2014 to 2015, in acute coronary syndrome patients and cardiogenic shock, and their short term outcome and survival. This is ongoing study planned to follow long term outcome as well.

    Literature

    1. Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, et al. IABP-SHOCK II Trial Investigators. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012;367(14):1287–96. https://doi.org/10.1056/NEJMoa1208410
    2. Sjauw KD, Engström AE, Vis MM, van der Schaaf RJ, Baan J, Koch KT, et al. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines? Eur Heart J. 2009;30(4):459–68. https://doi.org/10.1093/eurheartj/ehn602
    Cardiologia Croatica
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    Use of intra-aortic balloon pump in patients with acute coronary syndrome and cardiogenic shock at the University Hospital Centre Osijek, in the period from 2014 to 2015

    Abstract
    Issue3-4
    Published
    Pages101
    PDF via DOIhttps://doi.org/10.15836/ccar2016.101
    intra-aortic balon pump
    shock
    acute coromary syndrome

    Authors

    Zorin Makarović*ORCIDUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
    Sandra MakarovićORCIDUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
    Damir KirnerORCIDUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
    Robert SteinerORCIDUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
    Ivica BošnjakORCIDUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
    Marin VučkovićUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
    Dragan NovoselORCIDUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia
    Dražen MlinarevićORCIDUniversity of Osijek School of Medicine, University Hospital Centre Osijek, Osijek, Croatia

    *Correspondence email: zorinmakarovic2@net.hr

    Full Text

    There are conflicting evidence regarding the use of intra-aortic balon pump (IABP) in acute coronary syndrome and shock patients. (1, 2) Current European Society of Cardiology (ESC) Guidelines does not recommend IABP to be routinely used. It is intended to be used in patients with non ST-segment elevation myocardial infarction (NSTEMI) with acute mechanical complications. ESC Guidelines considered meta-analyses by Sjauw el al and the major randomized clinical trial IABP SHOCK II. This research did not confirm degraded mortality 30 days after ST-segment elevation myocardial infarction (STEMI) with shock. There are several flaws to this study: the absence of long-term survival, not taking into account patients with mechanical complications of myocardial infarction, NSTEMI patients and cardiogenic shock after 12 hours. 50% of patients had blood pressure ≥ 90 mmHg, which rise the question of inclusion criteria. However, meta-analyses showed significant reduction in mortality in cardiogenic shock after STEMI in patients treated with thrombolysis and IABP, but without primary percutaneous coronary intervention. New randomized clinical trials are needed, so that a definite conclusion on long-term survival could be made, as well to establish if there are groups within those patients, which could benefit from the use of IABP.

    We present our IABP experience, in University Hospital Centre Osijek, in time period from 2014 to 2015, in acute coronary syndrome patients and cardiogenic shock, and their short term outcome and survival. This is ongoing study planned to follow long term outcome as well.

    Literature

    1. 1.
      Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, et al. IABP-SHOCK II Trial Investigators. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012;367(14):1287–96.DOI
    2. 2.
      Sjauw KD, Engström AE, Vis MM, van der Schaaf RJ, Baan J, Koch KT, et al. A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines? Eur Heart J. 2009;30(4):459–68.DOI