Iranian Heart Journal

Iranian Heart Journal

Outcomes of STEMI Complicated by Cardiogenic Shock With and Without IABP

Document Type : Original Article

Authors
Mahesh Kumar Batra 1
Kamran Ahmed Khan 2
Tahir Saghir 2
Lajpat Rai 3
Jawaid Akbar Sial 1
Rajesh Kumar 1
Muhammad Naeem Mengal 1
Omer Saqib 1
Naveedullah Khan 1
Sanam Khowaja 1
Nadeem Hasan Rizvi 1
Nadeem Qamar 1
Abdul Samad Achakzai 1
Ashok Kumar 3
Musa Karim 1
1 National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan.
2 National Institute of Cardiovascular Diseases (NICVD), Karachi; Pakistan.
3 National Institute of Cardiovascular Diseases (NICVD), Hyderabad, Pakistan.
Abstract
Background: The results of the IABP-SHOCK II trial did not encourage the use of an intra-aortic balloon pump (IABP) in cardiogenic shock (CS) with ST-elevation myocardial infarction (STEMI). We aimed to determine whether these findings may be applicable to our population in the South Asian region, as there is a paucity of data.
 
Methods: In this prospective cohort study, 2 independent cohorts of STEMI patients with CS were recruited based on the utilization of IABP during revascularization. The primary endpoints of in-hospital and after 30 days of major adverse cardiac events (MACE) and the secondary endpoint of any major bleed were compared between the 2 cohorts.
 
Results: In total, each cohort consisted of 130 patients. Demographic, clinical, and angiographic profiles were comparable in the 2 cohorts. In the IABP and non-IABP cohorts, the in-hospital and 30-day mortality rates were 19.2% vs 26.2%; P=0.183 and 30.8% vs 36.9%; P=0.358, respectively, while the MACE rates were 20.8% vs 26.2%; P=0.306 and 32.3% vs 36.9%; P=0.434, respectively. Cardiac catheterization laboratory death was 0.8% vs 5.4%; P=0.031 and the major bleed was 4.6% vs 3.8%; P=0.758, among patients managed with IABP and without IABP, respectively.
 
Conclusions: Our study concluded that while there was no significant difference in the overall outcome, there was a lower trend in in-hospital mortality and significantly lower cardiac catheterization laboratory death with the use of IABP. However, the in-hospital and 30-day MACE were comparable in both groups. (Iranian Heart Journal 2023; 24(1): 69-77)
Keywords
Acute myocardial infarction
Cardiogenic shock
Revascularization
IABP
MACE
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Iranian Heart Journal
Volume 24, Issue 1
Winter 2023
Pages 69-77