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Updated: Jul 18, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
[Prophylactic intraaortic balloon pumping preserves left ventricular systolic function in acute anterior myocardial
Tomiharu Niida1, Tadamichi Sakuma, Chikaaki Motoda
1Division of Cardiology, Cardiovascular Center, Tsuchiya General Hospital, Hiroshima. tasakum@hotmail.com
Insights
Prophylactic intraaortic balloon pumping before primary percutaneous coronary intervention improves left ventricular function in high-risk acute myocardial infarction patients. This approach reduces major cardiac events and mortality compared to rescue use.
Area of Science:
- Cardiology
- Interventional Cardiology
- Acute Myocardial Infarction Management
Context:
- Acute myocardial infarction (AMI) management involves restoring blood flow via primary percutaneous coronary intervention (PCI).
- Intraaortic balloon pumping (IABP) is used to support patients with AMI, particularly those in cardiogenic shock.
- The role of prophylactic IABP in non-shock AMI patients undergoing primary PCI remains an area of investigation.
Purpose:
- To evaluate the impact of prophylactic intraaortic balloon pumping (IABP) versus rescue IABP on left ventricular (LV) function and prognosis in patients with anterior acute myocardial infarction (AMI) without cardiogenic shock undergoing primary PCI.
Summary:
- Fifty-eight patients with first AMI were studied; 25 had cardiogenic shock, 33 did not.
- Non-shock anterior AMI patients were divided into prophylactic IABP (Group 1) and rescue IABP (Group 2).
- Group 1 showed superior convalescent LV ejection fraction (48.7% vs. 37.8%, p=0.03) and 0% 30-day mortality versus 11% in Group 2.
Impact:
- Prophylactic IABP preserves LV systolic function post-anterior AMI in high-risk patients without cardiogenic shock.
- This strategy may reduce subsequent major cardiac events and mortality.
- Findings support considering prophylactic IABP in select AMI patients to improve outcomes.
Objectives:
Left ventricular function and prognosis were evaluated in patients with acute myocardial infarction who underwent primary percutaneous coronary intervention supported by intraaortic balloon pumping.
Methods:
Fifty-eight consecutive patients with first acute myocardial infarction were treated between July 1999 and April 2006. Twenty-five had cardiogenic shock on admission, whereas 33 did not. Patients with anterior acute myocardial infarction without cardiogenic shock were divided into the prophylactic intraaortic balloon pumping group (Group 1; n=17) and the rescue intraaortic balloon pumping group (Group 2; n=9).
Results:
Thirty-day in-hospital mortality was 52% in cardiogenic shock patients, and 3% in non-shock patients. Baseline characteristics of non-shock anterior acute myocardial infarction were similar including Thrombolysis in Myocardial Infarction (TIMI) risk scores (5.1 and 5.0) in the two groups. However, average left ventricular ejection fraction in the convalescent stage was superior in Group 1 (48.7% vs. 37.8%, p = 0.03). Thirty-day in-hospital mortality was 0% in Group 1 and 11% in Group 2 (p = 0.34). Cox's hazard ratio in Group 2 to Group 1 was 2.38 (95% confidence intrerval; 0.84-11.1, p = 0.09) in terms of the subsequent major cardiac events.
Conclusions:
Prophylactic use of intraaortic balloon pumping starting prior to primary percutaneous coronary intervention preserves the convalescent left ventricular systolic function in patients with high risk for anticipated cardiac events after anterior acute myocardial infarction without cardiogenic shock.
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