title: Clinical outcomes of the intra-aortic balloon pump for resuscitated patients with acute myocardial infarction complicated by cardiac arrest.
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.
  
  
  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).
  
  
  CONCLUSIONS
  The use of IABP did not show clinical benefits in patients with AMI complicated by severe cardiogenic shock after propensity matching analysis.
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Hyun Kuk
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea. Electronic address: myungho@chollian.net.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.affiliation: Kyungpook National University Hosptial, Daegu, South Korea.
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.affiliation: Yeungnam University Hospital, Daegu, South Korea.
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Keimyung University Hospital, Daegu, South Korea.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.affiliation: Busan National University Hospital, Busan, South Korea.
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.affiliation: Yonsei University Severans Hospital, Seoul, South Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Choi
authors.affiliation: Chungbuk National University Hospital, Cheongju, South Korea.
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.affiliation: Kyunghee University Hospital, Seoul, South Korea.
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Catholic University Hospital, Seoul, South Korea.
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.affiliation: Yonsei University Severans Hospital, Seoul, South Korea.
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.affiliation: Korea University Hospital, Seoul, South Korea.
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Konyang University Hospital, Daejeon, South Korea.
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Ulsan University Hospital, Seoul, South Korea.
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D057216:Propensity Score; D056910:Republic of Korea / Q000453:epidemiology; D012770:Shock, Cardiogenic / Q000628:therapy
keywords: Cardiogenic shock; Intra-aortic balloon pump; Myocardial infarction