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

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.