What is the evidence for IABP in STEMI with and without cardiogenic shock?

Therapeutic Advances in Cardiovascular Disease
Suzanne de WahaHolger Thiele

Abstract

Intraaortic balloon pump (IABP) is the most widely used left ventricular support device in a variety of indications. This review focuses on the current literature and discusses the evidence of IABP in ST-elevation myocardial infarction (STEMI) with and without cardiogenic shock. In high-risk STEMI patients without cardiogenic shock several randomized clinical trials have been performed. The majority of the studies could not demonstrate an efficacy benefit for IABP as adjunctive therapy in comparison to standard treatment alone. Hence, recent meta-analyses could not reveal diverging mortality rates at a higher incidence of stroke and major bleedings with IABP use independent of the type of reperfusion therapy. IABP in STEMI patients with cardiogenic shock is recommended according to current American College of Cardiology/American Heart Association (AHA/ACC) and European Society of Cardiology (ESC) guidelines. In recent meta-analyses, IABP in cardiogenic shock complicated by STEMI has been shown to be associated with decreased mortality. However, these beneficial effects are limited to patients treated with thrombolysis, whereas in patients undergoing mechanical revascularization IABP therapy is associated with an increase in mor...Continue Reading

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Citations

Oct 4, 2014·Journal of the American College of Cardiology·Robert StretchPramod Bonde
Sep 29, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Armindo FernandesAndré Denault
Jan 30, 2018·The Cochrane Database of Systematic Reviews·Julia SchumannSusanne Unverzagt
Jan 5, 2014·The Cochrane Database of Systematic Reviews·Susanne UnverzagtRoland Prondzinsky
Dec 6, 2017·Medizinische Klinik, Intensivmedizin und Notfallmedizin·R ProndzinskyS Unverzagt

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Methods Mentioned

BETA
coronary artery bypass

Clinical Trials Mentioned

NCT00491036

Related Concepts

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Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.