Findings in patients expected to undergo revascularization for MI with cardiogenic shock
WEDNESDAY, Aug. 29 (HealthDay News) -- In patients with cardiogenic shock complicating acute myocardial infarction, for whom early revascularization strategy is planned, intraaortic balloon counterpulsation does not significantly lower 30-day mortality, according to a study published online Aug. 27 in the New England Journal of Medicine to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 25 to 29 in Munich.
Holger Thiele, M.D., from the University of Leipzig-Heart Center in Germany, and colleagues conducted a multicenter, randomized trial in which patients with cardiogenic shock complicating acute myocardial infarction were assigned to intraaortic balloon counterpulsation (IABP group; 300 patients) or to a control group (298 patients). Early revascularization by either percutaneous coronary intervention or bypass was expected in all patients.
The researchers found that, at 30 days, 39.7 percent of patients in the IABP group and 41.3 in the control group had died (relative risk with IABP, 0.96; P = 0.69). For secondary end points or in-process-of-care measures (time to hemodynamic stabilization, intensive care unit length of stay, serum lactate levels, renal function, and dose and duration of catecholamine therapy) there were no significant differences between the groups, nor were there any significant differences for safety assessments (major bleeding, peripheral complications, sepsis, and stroke).
"In this large, randomized trial involving patients with cardiogenic shock complicating acute myocardial infarction, for whom early revascularization was planned, intraaortic balloon pump support did not reduce 30-day mortality," the authors write.
Several authors disclosed financial ties to pharmaceutical and medical device companies, including Maquet Cardiopulmonary, which together with Teleflex Medical provided unrestricted grants for the research.