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Clinical outcomes of the intra-aortic balloon pump for resuscitated patients with acute myocardial infarction complicated by cardiac arrest.

Authors
 Hyun Kuk Kim  ;  Myung Ho Jeong  ;  Youngkeun Ahn  ;  Doo Sun Sim  ;  Shung Chull Chae  ;  Young Jo Kim  ;  Seung Ho Hur  ;  In Whan Seong  ;  Taek Jong Hong  ;  Dong Hoon Choi  ;  Myeong Chan Cho  ;  Chong Jin Kim  ;  Ki Bae Seung  ;  Yang Soo Jang  ;  Seung Woon Rha  ;  Jang Ho Bae  ;  Jeong Gwan Cho  ;  Seung Jung Park 
Citation
 JOURNAL OF CARDIOLOGY, Vol.67(1) : 57-63, 2016 
Journal Title
 JOURNAL OF CARDIOLOGY 
ISSN
 0914-5087 
Issue Date
2016
MeSH
Aged ; Cardiopulmonary Resuscitation* ; Case-Control Studies ; Cohort Studies ; Female ; Heart Arrest/mortality* ; Heart Arrest/therapy* ; Humans ; Intra-Aortic Balloon Pumping* ; Male ; Myocardial Infarction/mortality* ; Myocardial Infarction/therapy* ; Propensity Score ; Republic of Korea/epidemiology ; Shock, Cardiogenic/therapy
Keywords
Cardiogenic shock ; Intra-aortic balloon pump ; Myocardial infarction
Abstract
BACKGROUND: The aim of this study was to investigate the clinical effects of intra-aortic balloon pump (IABP) in patients who received cardiopulmonary resuscitation (CPR) before procedure. METHODS AND RESULTS: Between November 2005 and April 2014, 49,542 patients were enrolled in a prospective cohort study for acute myocardial infarction (AMI) in Korea (KAMIR). CPR was performed in 1700 patients with cardiac arrest. Patients were excluded from the study if they had not undergone a coronary angiogram, if extracorporeal membrane oxygenation or thrombolysis was performed, and if mechanical complications presented. The primary end point was 1-month all-cause mortality. A total of 883 patients in the IABP group and 476 in the control group were included. During the 1-month follow-up, all-cause death occurred in 749 patients (55.1%). The IABP group was predominantly male and had a higher prevalence of ST-segment elevation MI and a higher risk of coronary lesions including left main disease and three-vessel disease. Glycoprotein IIb/IIIa inhibitor was administered less in the non-IABP group. In the total population, the IABP group had worse outcomes in terms of mortality rates after multivariate analysis [hazard ratio (HR) 1.22, 95% confidence interval (CI) 1.02-1.47, p=0.034] without increasing the incidence of recurrent MI, stroke, and major bleeding. After propensity matching with a pair of 452 patients, no significant differences were observed in baseline characteristics or clinical outcomes (HR 1.21, 95% CI 0.93-1.57, p=0.158). CONCLUSION: The use of IABP did not show clinical benefits in patients with AMI complicated by severe cardiogenic shock after propensity matching analysis.
Full Text
http://www.sciencedirect.com/science/article/pii/S0914508715001239
DOI
10.1016/j.jjcc.2015.04.007
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146351
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