Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction : Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial

Medientyp: E-Artikel
Titel: Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction : Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial : Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial
Beteiligte: Thiele, Holger; Zeymer, Uwe; Thelemann, Nathalie; Neumann, Franz-Josef; Hausleiter, Jörg; Abdel-Wahab, Mohamed; Meyer-Saraei, Roza; Fuernau, Georg; Eitel, Ingo; Hambrecht, Rainer; Böhm, Michael; Werdan, Karl; Felix, Stephan B.; Hennersdorf, Marcus; Schneider, Steffen; Ouarrak, Taoufik; Desch, Steffen; de Waha-Thiele, Suzanne; Alkisoglu, Zehra; Follath, Ferenc; Frey, Sonja; Haerting, Johannes; Huber, Kurt; Maisch, Bernhard; [...]
Erschienen: Ovid Technologies (Wolters Kluwer Health), 2019
Erschienen in: Circulation
Sprache: Englisch
DOI: 10.1161/circulationaha.118.038201
ISSN: 1524-4539; 0009-7322
Schlagwörter: Physiology (medical) ; Cardiology and Cardiovascular Medicine
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Beschreibung: <jats:sec> <jats:title>Background:</jats:title> <jats:p>The role of intraaortic balloon counterpulsation (IABP) in cardiogenic shock is still a subject of intense debate despite the neutral results of the IABP-SHOCK II trial (Intraaortic Balloon Pump in Cardiogenic Shock II) with subsequent downgrading in international guidelines. So far, randomized data on the impact of IABP on long-term clinical outcomes in patients with cardiogenic shock complicating acute myocardial infarction are lacking. Furthermore, only limited evidence is available on general long-term outcomes of patients with cardiogenic shock treated by contemporary practice.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>The IABP-SHOCK II trial is a multicenter, randomized, open-label trial. Between 2009 and 2012, 600 patients with cardiogenic shock complicating acute myocardial infarction undergoing early revascularization were randomized to IABP versus control.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> Long-term follow-up was performed 6.2 years (interquartile range 5.6–6.7) after initial randomization. Follow-up was completed for 591 of 600 patients (98.5%). Mortality was not different between the IABP and the control group (66.3% versus 67.0%; relative risk, 0.99; 95% CI, 0.88–1.11; <jats:italic>P</jats:italic> =0.98). There were also no differences in recurrent myocardial infarction, stroke, repeat revascularization, or rehospitalization for cardiac reasons (all <jats:italic>P</jats:italic> >0.05). Survivors’ quality of life as assessed by the EuroQol 5D questionnaire and the New York Heart Association class did not differ between groups. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>IABP has no effect on all-cause mortality at 6-year long-term follow-up. Mortality is still very high, with two thirds of patients with cardiogenic shock dying despite contemporary treatment with revascularization therapy.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trial Registration:</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov/">https://www.clinicaltrials.gov/</jats:ext-link> . Unique identifier: NCT00491036. </jats:p> </jats:sec>
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