Randomized comparison of intra-aortic balloon support with a percutaneous left ventricular assist device in patients with revascularized acute myocardial infarction complicated by cardiogenic shock

摘要: Aims Mortality in cardiogenic shock (CS) following acute myocardial infarction (AMI) remains unacceptably high despite percutaneous coronary intervention (PCI) of the infarcted artery and use intra-aortic balloon pump (IABP) counterpulsation. A newly developed left ventricular assist device (VAD) (Tandem Heart™, Cardiac Assist, Pittsburgh, PA, USA) with active circulatory support might have positive haemodynamic effects decrease mortality. Methods results Patients CS after AMI, intended PCI artery, were randomized to either IABP ( n =20) or VAD =21). The primary outcome measure cardiac power index, as well other metabolic variables, could be improved more effectively by from 0.22 [interquartile range (IQR) 0.19–0.30] 0.37 W/m2 (IQR 0.30–0.47, P <0.001) when compared 0.18–0.30) 0.28 W/m2 0.24–0.36, =0.02; =0.004 for intergroup comparison). However, complications like severe bleeding =19 vs. =8, =0.002) limb ischaemia =7 =0, =0.009) encountered frequently support, whereas 30 day mortality was similar (IABP 45% 43%, log-rank, =0.86). Conclusion Haemodynamic parameters can reversed than standard treatment IABP. highly invasive procedure extracorporeal support.