Arthur Reshad Garan, Arvind Bhimaraj, Rachna Kataria, Aniket Rali, E Wilson Grandin, Alvaro Delgado, Ajar Kochar, Borui Li, Manreet K Kanwar, Shashank S Sinha, Jaime Hernandez-Montfort, Jacob Abraham, Song Li, Alexandra Arias-Mendoza, Hiram Bezerra, Vanessa Blumer, I-Hui Chiang, Mary Jane Farr, Justin Fried, Ann Gage, Shelley Hall, Gavin W Hickey, Onyedika Ilonze, Maya Guglin, Wissam Khalife, Ju Kim, Scott Lundgren, Jeffrey Marbach, Joseph Mishkin, Sandeep Nathan, Mohit Pahuja, Andrew Schwartzman, Van-Khue Ton, Oleg Alec Vishnevsky, Esther Vorovich, Joyce Wald, Elric Zweck, Qiuyue Kong, Paavni Sangal, Karol D Walec, Peter Zazzali, Neil M Harwani, Kevin John, Claudius Mahr, Daniel Burkhoff, Navin K Kapur
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引用次数: 0
Abstract
Background: Intra-aortic balloon pump (IABP) insertion has not been shown to improve mortality in acute myocardial infarction-related cardiogenic shock (AMI-CS) but is increasingly used in heart failure-related cardiogenic shock (HF-CS).
Objective: We sought to compare IABP-related outcomes in HF-CS and AMI-CS patients.
Methods: The Cardiogenic Shock Working Group registry was queried for CS patients receiving femoral IABP as the first temporary mechanical circulatory support (tMCS) device. Patients were divided into those with AMI-CS or HF-CS and were excluded if they received the IABP in conjunction with VA-ECMO or another device concomitantly. Outcomes including rates of native heart survival (NHS, i.e. weaned from IABP and discharged), heart replacement therapy (HRT, i.e. bridge to durable left ventricular assist device or heart transplant), need for another tMCS device, and death were recorded and compared between the two cohorts.
Results: In total, 886 patients were supported by IABP as the first tMCS device; of these, 407 (45.6%) had HF-CS and 384 (43.3%) AMI-CS. Those with HF-CS were younger but had a higher burden of cardiovascular co-morbidities than those with AMI-CS. Among the HF-CS cohort, 33.2% had NHS and 26.7% were bridged to HRT without another tMCS device. In the AMI-CS cohort, 43.4% had NHS and 2.1% were bridged to HRT without another tMCS device. Mortality was higher in AMI-CS (36.4% vs 20.6%, p<0.001). Complication rates were higher in AMI-CS and those needing another tMCS device.
Conclusion: Patients with HF-CS were more likely to have a favorable outcome with IABP than those with AMI-CS.
背景：主动脉内球囊泵（IABP）的插入并未被证明可以改善急性心肌梗死相关性心源性休克（AMI-CS）的死亡率，但在心力衰竭相关性心源性休克（HF-CS）中的应用越来越多。目的：我们试图比较HF-CS和AMI-CS患者的iabp相关结局。方法：查询心源性休克工作组登记的接受股骨IABP作为第一个临时机械循环支持（tMCS）装置的CS患者。患者被分为AMI-CS或HF-CS，如果他们同时接受IABP与VA-ECMO或其他装置，则被排除在外。结果包括原生心脏存活率（NHS，即从IABP中断奶并出院），心脏替代治疗（HRT，即过渡到耐用的左心室辅助装置或心脏移植），另一个tMCS装置的需求，以及两个队列之间的死亡率进行记录和比较。结果：共有886例患者使用IABP作为第一tMCS装置；其中HF-CS 407例（45.6%），AMI-CS 384例（43.3%）。HF-CS患者更年轻，但心血管合并症的负担高于AMI-CS患者。在HF-CS队列中，33.2%的患者接受了NHS治疗，26.7%的患者在没有其他tMCS装置的情况下接受了HRT治疗。在AMI-CS队列中，43.4%的患者接受了NHS治疗，2.1%的患者在没有其他tMCS设备的情况下接受了HRT治疗。AMI-CS的死亡率更高（36.4% vs 20.6%）。结论：与AMI-CS相比，HF-CS患者更有可能在IABP治疗中获得良好的结果。
期刊介绍：
Journal of Cardiac Failure publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure - pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment.
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