title: Intra-aortic balloon counterpulsation reduces mortality in large anterior myocardial infarction complicated by persistent ischaemia: a CRISP-AMI substudy.
abstract: OBJECTIVE
  This substudy investigated IABP support in large STEMI complicated by persistent ischaemia within the original CRISP-AMI trial.
  
  
  RESULTS
  Patients were included if the ECG at admission showed summed ST deviation (ST-D) ≥15 mm and the ECG post PCI showed poor ST resolution (<50%). Endpoints evaluated were all-cause mortality at six months and the composite endpoint of death, cardiogenic shock or new or worsening heart failure at six months. One hundred and forty-nine patients had ST-D ≥15 mm (mean ST-D 24±8 mm). Of these patients, 36 (24%) showed poor ST resolution (15 patients in the IABP group; 21 patients in the control group). Mean age was 55±11 years, 89% were male. Mean systolic and diastolic blood pressures were 135±31 mmHg and 83±22 mmHg, respectively. The left anterior descending coronary artery was the infarct-related artery in all cases, primary PCI was successful in 94%. At six months, zero patients in the IABP group died versus five patients in the control group (0% versus 24%; p=0.046). There was a trend towards statistical significance in the composite endpoint (one patient [7%] versus seven patients [33%]; p=0.06).
  
  
  CONCLUSIONS
  In this substudy, use of IABP was associated with decreased six-month mortality in large STEMI complicated by persistent ischaemia after PCI.
authors.affiliation: Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
authors.forename: Lokien X
authors.initials: LX
authors.lastname: van Nunen
authors.forename: Marcel
authors.initials: M
authors.lastname: van 't Veer
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Schampaert
authors.forename: Marcel C M
authors.initials: MC
authors.lastname: Rutten
authors.forename: Frans N
authors.initials: FN
authors.lastname: van de Vosse
authors.forename: Manesh R
authors.initials: MR
authors.lastname: Patel
authors.forename: Nico H J
authors.initials: NH
authors.lastname: Pijls
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D007511:Ischemia / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D012306:Risk; D012770:Shock, Cardiogenic / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D016896:Treatment Outcome