title: Is Intra-Aortic Balloon Pump Counterpulsation Sufficient to Treat Patients in Cardiogenic Shock, Undergoing Primary Percutaneous Coronary Intervention.
abstract: BACKGROUND
  A high number of patients do not survive primary percutaneous coronary intervention (PCI) complicated by cardiogenic shock (CS), even when assisted with intra-aortic balloon pump (IABP) counterpulsation. There is no accepted consensus on who may most benefit from IABP counterpulsation, although previous retrospective studies have reported predictors of survival for patients undergoing PCI and cardiac surgery. To date, a risk model for emergency primary PCI patients has not been ascertained. The objective of this study was to identify independent predictors for in-hospital survival, to create a standardized risk model to predict patients who may require IABP insertion during primary PCI.
  
  
  METHODS
  Retrospective data were from 165 patients who had undergone primary PCI with IABP due to CS complicating acute myocardial infarction (AMI), from September 2007 to 2010, and underwent logistic regression analysis, to evaluate the incremental risk factors associated with survival.
  
  
  RESULTS
  The overall in-hospital mortality was 32.1% (53 patients). The incremental independent predictors for in-hospital survival were: patient age of less than 60 years (OR: 0.303, 95% CI: 0.11 - 0.83, P < 0.02) and the use of IABP support alone, as opposed to in adjunction with inotropic support (OR: 3.177, 95% CI: 1.159 - 8.708, P < 0.025).
  
  
  CONCLUSIONS
  This study illustrated an age of less than 60 years, and the use of IABP alone, to be independent predictors of in-hospital survival in patients with CS complicating AMI who undergo primary PCI assisted by IABP. No specific risk model could be determined.
authors.affiliation: University of Leeds, Leeds, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Paton
authors.affiliation: University of Leeds, Leeds, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ashton
authors.affiliation: Leeds Heart Centre, Leeds, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Pearson
authors.affiliation: Leeds Heart Centre, Leeds, UK.
authors.forename: Mohan
authors.initials: M
authors.lastname: Sivananthan
keywords: Cardiogenic shock; Intra-aortic balloon pump; Primary percutaneous coronary intervention; Risk model