Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction
| Autor: | Joanna J. Wykrzykowska, Ivo M. van Dongen, Karel T. Koch, Jan J. Piek, Erlend Eriksen, Jan Baan, Bas A.J.M. de Mol, Jan G.P. Tijssen, Krischan D. Sjauw, Robbert J. de Winter, Alexander Hirsch, Erik J S Packer, Dagmar M. Ouweneel, José P.S. Henriques, Wim K. Lagrand, Marije M. Vis |
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| Přispěvatelé: | Cardiology, Radiology & Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, Graduate School, APH - Aging & Later Life, ACS - Atherosclerosis & ischemic syndromes, Intensive Care Medicine, Cardiothoracic Surgery, ACS - Pulmonary hypertension & thrombosis, ACS - Heart failure & arrhythmias, ACS - Microcirculation |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Shock Cardiogenic Hemodynamics 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Multicenter trial Internal medicine medicine Humans 030212 general & internal medicine Myocardial infarction Prospective Studies Impella Intra-aortic balloon pump Intra-Aortic Balloon Pumping business.industry Cardiogenic shock Hazard ratio Middle Aged medicine.disease Treatment Outcome Shock (circulatory) Cardiology Female Heart-Assist Devices medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology, 69(3), 278-287. Elsevier Inc. Journal of the American College of Cardiology, 69(3), 278-287. Elsevier USA |
| ISSN: | 1558-3597 0735-1097 |
| DOI: | 10.1016/j.jacc.2016.10.022 |
| Popis: | Background Despite advances in treatment, mortality in acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) remains high. Short-term mechanical circulatory support devices acutely improve hemodynamic conditions. Objectives The aim of this study was to determine whether a new percutaneous mechanical circulatory support (pMCS) device (Impella CP, Abiomed, Danvers, Massachusetts) decreases 30-day mortality when compared with an intra-aortic balloon pump (IABP) in patients with severe shock complicating AMI. Methods In a randomized, prospective, open-label, multicenter trial, 48 patients with severe CS complicating AMI were assigned to pMCS (n = 24) or IABP (n = 24). Severe CS was defined as systolic blood pressure Results At 30 days, mortality in patients treated with either IABP or pMCS was similar (50% and 46%, respectively; hazard ratio with pMCS: 0.96; 95% confidence interval: 0.42 to 2.18; p = 0.92). At 6 months, mortality rates for both pMCS and IABP were 50% (hazard ratio: 1.04; 95% confidence interval: 0.47 to 2.32; p = 0.923). Conclusions In this explorative randomized controlled trial involving mechanically ventilated patients with CS after AMI, routine treatment with pMCS was not associated with reduced 30-day mortality compared with IABP. |
| Databáze: | OpenAIRE |
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