Korean Circ J.  2003 Jan;33(1):22-29. 10.4070/kcj.2003.33.1.22.

Predictive Factors of Survival for Intra-aortic Balloon Pump in Acute Myocardial Infarction Treated with Angioplasty

• Ahn MS
• Yoo BS
• Kim JY
• Ko JY
• Lee KH
• Kim WJ
• Jung HS
• Park IH
• Lee MO
• Kim SN
• Lee SH
• Hwang SO
• Yoon JH
• Choe KH

• KMID: 1637924
• DOI: http://doi.org/10.4070/kcj.2003.33.1.22

Abstract

BACKGROUND AND OBJECTIVES
Intra-aortic balloon pumps (IABP) are useful tools for hemodynamic support in patients with hemodynamic instability or cardiogenic shock due to acute myocardial infarction (AMI). The purpose of this study was to examine the clinical characteristics and outcomes in patients with AMI who underwent IABP support, and to identify predictors of in-hospital mortality.
SUBJECTS AND METHODS
We retrospectively analyzed 46 consecutive patients with an acute myocardial infarction, who underwent primary or rescue percutaneous coronary intervention, with IABP support, between March 1997 and June 2002. The patients were divided into survivors and non-survivors. We compared the clinical characteristics, hemodynamic parameters and therapeutic outcomes between the two groups, and assessed the clinical and angiographic predictors of in-hospital mortality.
RESULTS
The overall survival rate was 39%. The indications of IABP support were cardiogenic shock (50%), unstable hemodynamics during coronary angioplasty (13%) and high risk intervention (35%). There were no significant differences in clinical diagnosis, infarct location, Killips classification, risk factors, ejection fraction, pain to balloon time, clinical indications for IABP, extents of coronary artery disease and left ventricular end diastolic pressure between the two groups. The survival group was younger than the non-survival group (p=0.04), and the TIMI III flow after PCI was more frequent in the survival group (p=0.01). The TIMI III flow was a predictor of in-hospital mortality (p=0.01).
CONCLUSION
The predictive factor of survival following IABP was the TIMI III flow in patients with AMI who underwent primary or rescue PCI.

Keyword

Myocardial infarction; Shock; Angioplasty; Intra-arotic balloon pumping

MeSH Terms

Angioplasty*
Blood Pressure
Classification
Coronary Artery Disease
Diagnosis
Hemodynamics
Hospital Mortality
Humans
Myocardial Infarction*
Percutaneous Coronary Intervention
Retrospective Studies
Risk Factors
Shock
Shock, Cardiogenic
Survival Rate
Survivors