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Updated: May 25, 2025
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
In-Hospital Mortality Predictors in Patients with Acute Myocardial Infarction and Cardiogenic Shock Using
Rossana Dall'Orto Elias1,2, Isabella Pedrosa Assunção1, Julliane Vasconcelos Joviano Santos2
1Biocor Instituto, Nova Lima, MG - Brasil.
Insights
Intra-aortic balloon pump (IABP) use in ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock (CS) is linked to reduced mortality in younger patients with dyslipidemia. Effectiveness is enhanced when IABP is used for two or more days.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Medical Devices
Background:
- ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock (CS) carries a high mortality risk.
- Intra-aortic balloon pump (IABP) is a widely used mechanical support, despite guideline downgrades.
- Predictors of IABP effectiveness in STEMI with CS remain underexplored.
Purpose of the Study:
- To identify clinical predictors of intra-aortic balloon pump (IABP) effectiveness in reducing in-hospital mortality.
- To analyze factors influencing IABP outcomes in patients with STEMI and CS.
Main Methods:
- Retrospective, observational, single-center study of 98 patients with STEMI and CS treated with IABP.
- Comparison of clinical characteristics between survivors and non-survivors.
- Statistical analysis to determine predictors of in-hospital mortality.
Main Results:
- IABP use within 1 day of infarction increased in-hospital death risk (OR: 0.12; p=0.034).
- Younger age (OR: 1.09; p=0.010) and dyslipidemia (OR: 0.19; p=0.024) predicted reduced mortality.
- Each year increase in age correlated with a 1.07-fold increase in death risk.
Conclusions:
- IABP use for ≥2 days, younger patient age, and presence of dyslipidemia are associated with reduced in-hospital mortality in STEMI with CS.
- These findings suggest specific patient profiles may benefit more from IABP therapy.
- Further research is warranted to validate these predictors.
Background:
Patients with ST-segment elevation myocardial infarction (STEMI) and cardiogenic shock (CS) have a high risk of death. New types of mechanical devices have limited availability in Brazil. The use of intra-aortic balloon pump (IABP), although new guidelines downgraded its recommendation, is the most widely used mechanical support strategy. However, little is known about the clinical predictors of its effectiveness in reducing mortality in this group of patients.
Objectives:
To assess the predictors of IABP effectiveness in reducing in-hospital mortality in patients with STEMI and CS.
Methods:
This observational, retrospective, descriptive, single-center study involved 98 patients with STEMI and CS treated with IABP, in an intensive care unit. We compared patients who survived (42 men and 13 women) and those did not (30 men and 13 women) using clinical predictors of IABP effectiveness in reducing in-hospital death, considering a statistical significance level of 5% (p < 0.05).
Results:
The use of IABP in patients less than 1 day after infarction (odds ratio [OR]: 0.12; 95% confidence interval [CI]: 0.02 to 0.85; p = 0.034) was a factor that increased the risk of in-hospital death. Younger age (OR: 1.09; 95% CI: 1.02 to 1.16; p = 0.010) and dyslipidemia (OR: 0.19; 95% CI: 0.05 to 0.81; p = 0.024) were predictors of reduced in-hospital mortality. For each additional year of age, the risk of death increased 1.07-fold.
Conclusion:
In patients with STEMI and CS, the use of IABP reduced in-hospital mortality when it was used for 2 or more days, as well as in younger patients and those with dyslipidemia. Additional studies are needed to confirm these findings.
