Cardiology in critical care · Mechanical support in cardiogenic shock
Intraaortic balloon support for myocardial infarction with cardiogenic shock
| Design | Multicentre randomised controlled trial |
|---|---|
| Treatment | Intra-aortic balloon counterpulsation |
| Control | No balloon pump |
| Population | 598 patients with cardiogenic shock complicating acute myocardial infarction, with planned early revascularisation |
| Follow-up | 12 months |
| Primary endpoint | 30-day all-cause mortality |
| Result | At 30 days, 119 of 300 (39.7%) in the balloon pump group and 123 of 298 (41.3%) in the control group had died. Major bleeding did not differ, 3.3% with the balloon pump versus 4.4% without. |
| Secondary endpoints | Reinfarction, stroke, bleeding, renal failure, length of stay |
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.
The trial authors, in the published abstract
Removed a device that had been in routine use for decades on physiological reasoning alone. It set the pattern that ECMO-CS and ECLS-SHOCK followed, and makes DanGer Shock's positive result all the more notable.
Thiele H, Zeymer U, Neumann FJ, et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 2012 Oct 4;367(14):1287-96.