Circulation, Vol 90, 792-799, Copyright © 1994 by American Heart Association
EM Ohman, BS George, CJ White, MJ Kern, PA Gurbel, RJ Freedman, C Lundergan, JR Hartmann, JD Talley and MJ Frey
BACKGROUND: Aortic counterpulsation has been observed to reduce the rate of
reocclusion of the infarct-related artery after patency has been restored
during acute myocardial infarction in observational studies. To evaluate
the benefit-to-risk ratio of aortic counterpulsation during the early phase
of myocardial infarction, a multicenter randomized clinical trial was
performed. METHODS AND RESULTS: Patients who had patency restored during
acute cardiac catheterization within the first 24 hours of onset of
myocardial infarction were randomly assigned to aortic counterpulsation for
48 hours versus standard care. Intravenous heparin was used similarly in
both groups and was continued for a median (25th, 75th percentile) of 5
(2,7) days. A total of 182 patients were enrolled; 96 were assigned to
aortic counterpulsation and 86 to standard care. Repeat cardiac
catheterization was performed at a median of 5 (4,6) days after
randomization in 89% of patients assigned to aortic counterpulsation and in
90% of control patients. Patients randomized to aortic counterpulsation had
similar rates of severe bleeding complications (2% versus 1%), number of
units of blood transfused (mean, 1.3 +/- 2.6 versus 0.9 +/- 1.8 units), and
vascular repair or thrombectomy (5% versus 2%) compared with patients
treated in a conventional manner. Patients randomized to aortic
counterpulsation had significantly less reocclusion of the infarct-related
artery during follow-up compared with control patients (8% versus 21%, P
< .03). In addition, there was a significantly lower event rate in
patients assigned to aortic counterpulsation in terms of a composite
clinical end point (death, stroke, reinfarction, need for emergency
revascularization with angioplasty or bypass surgery, or recurrent
ischemia): 13% versus 24%, P < .04. CONCLUSIONS: This randomized trial
showed that careful use of prophylactic aortic counterpulsation can prevent
reocclusion of the infarct-related artery and improve overall clinical
outcome in patients undergoing acute cardiac catheterization during
myocardial infarction.
ARTICLES
Use of aortic counterpulsation to improve sustained coronary artery patency during acute myocardial infarction. Results of a randomized trial. The Randomized IABP Study Group
Duke University Medical Center, Durham, NC 27710.
This article has been cited by other articles:
 |
|
 |
|
  K. D. Sjauw, A. E. Engstrom, M. M. Vis, R. J. van der Schaaf, J. Baan Jr, K. T. Koch, R. J. de Winter, J. J. Piek, J. G.P. Tijssen, and J. P.S. Henriques A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines? Eur. Heart J., February 2, 2009; 30(4): 459 - 468. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. George and M. C. Oz Myocardial Revascularization after Acute Myocardial Infarction Card. Surg. Adult, January 1, 2008; 3(2008): 669 - 696. [Full Text]
|
|
|
|
 |
|
 C. S. Duvernoy and E. R. Bates Management of Cardiogenic Shock Attributable to Acute Myocardial Infarction in the Reperfusion Era J Intensive Care Med, July 1, 2005; 20(4): 188 - 198. [Abstract] [PDF]
|
|
|
|
 |
|
 A. G. C. Sutton, P. G. Campbell, R. Graham, D. J. A. Price, J. C. Gray, E. D. Grech, J. A. Hall, A. A. Harcombe, R. A. Wright, R. H. Smith, et al. A randomized trial of rescue angioplasty versus a conservative approach for failed fibrinolysis in ST-segment elevation myocardial infarction: The Middlesbrough Early Revascularization to Limit INfarction (MERLIN) trial J. Am. Coll. Cardiol., July 21, 2004; 44(2): 287 - 296. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G Montalescot, H R Andersen, D Antoniucci, A Betriu, M J de Boer, L Grip, F J Neumann, and M T Rothman Recommendations on percutaneous coronary intervention for the reperfusion of acute ST elevation myocardial infarction Heart, June 1, 2004; 90(6): e37 - e37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. C. Amado, D. L. Kraitchman, B. L. Gerber, E. Castillo, R. C. Boston, J. Grayzel, and J. A. C. Lima Reduction of "no-reflow" phenomenon by intra-aortic balloon counterpulsation in a randomized magnetic resonance imaging experimental study J. Am. Coll. Cardiol., April 7, 2004; 43(7): 1291 - 1298. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Cohen, P. Urban, J. T. Christenson, D. L. Joseph, R. J. Freedman Jr, M. F. Miller, E.M. Ohman, R. C. Reddy, G. W. Stone, J. J. Ferguson III, et al. Intra-aortic balloon counterpulsation in US and non-US centres: results of the Benchmark(R) Registry Eur. Heart J., October 1, 2003; 24(19): 1763 - 1770. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Arceo, P. Urban, P.-A. Dorsaz, P. Chatelain, V. Verin, C. Suilen, E. Rombaut, and J.-C. Chevrolet In-Hospital Complications of Percutaneous Intraaortic Balloon Counterpulsation Angiology, September 1, 2003; 54(5): 577 - 585. [Abstract] [PDF]
|
|
|
|
|
|
G. W. Stone, E. M. Ohman, M. F. Miller, D. L. Joseph, J. T. Christenson, M. Cohen, P. M. Urban, R. C. Reddy, R. J. Freedman, K. L. Staman, et al. Contemporary utilization and outcomes of intra-aortic balloon counterpulsation in acute myocardial infarction: The benchmark registry J. Am. Coll. Cardiol., June 4, 2003; 41(11): 1940 - 1945. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Low Intra-aortic balloon counterpulsation in acute myocardial infarction: too few or too many? J. Am. Coll. Cardiol., June 4, 2003; 41(11): 1946 - 1947. [Full Text] [PDF]
|
|
|
|
|
|
D. C. Lee, W. Ting, and M. C. Oz Myocardial Revascularization after Acute Myocardial Infarction Card. Surg. Adult, January 1, 2003; 2(2003): 639 - 658. [Full Text]
|
|
|
|
|
|
J. J. Ferguson III, M. Cohen, R. J. Freedman Jr, G. W. Stone, M. F. Miller, D. L. Joseph, and E. M. Ohman The current practice of intra-aortic balloon counterpulsation: results from the Benchmark Registry J. Am. Coll. Cardiol., November 1, 2001; 38(5): 1456 - 1462. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. I. Barbash, Y. Birnbaum, K. Bogaerts, M. Hudson, E. Lesaffre, Y. Fu, S. Goodman, K. Houbracken, K. Munsters, C. B. Granger, et al. Treatment of Reinfarction After Thrombolytic Therapy for Acute Myocardial Infarction : An Analysis of Outcome and Treatment Choices in the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO I) and Assessment of the Safety of a New Thrombolytic (ASSENT 2) Studies Circulation, February 20, 2001; 103(7): 954 - 960. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A de Belder CORONARY DISEASE: Acute myocardial infarction: failed thrombolysis Heart, January 1, 2001; 85(1): 104 - 112. [Full Text]
|
|
|
|
 |
|
 J. T. Christenson, F. Simonet, and M. Schmuziger Economic impact of preoperative intraaortic balloon pump therapy in high-risk coronary patients Ann. Thorac. Surg., August 1, 2000; 70(2): 510 - 515. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A G C Sutton, P G Campbell, E D Grech, D J A Price, A Davies, J A Hall, M J Stewart, and M A de Belder Failure of thrombolysis: experience with a policy of early angiography and rescue angioplasty for electrocardiographic evidence of failed thrombolysis Heart, August 1, 2000; 84(2): 197 - 204. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. E. Goldman and M. J. Eisenberg Identification and Management of Patients with Failed Thrombolysis after Acute Myocardial Infarction Ann Intern Med, April 4, 2000; 132(7): 556 - 565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E Straumann, S Yoon, B Naegeli, J Frielingsdorf, A Gerber, E Schuiki, and O Bertel Hospital transfer for primary coronary angioplasty in high risk patients with acute myocardial infarction Heart, October 1, 1999; 82(4): 415 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Deniz Kumbasar, E. Semiz, O. Sancaktar, S. Yalcinkaya, C. Ermis, and N. Deger Concomitant Use of Intraaortic Balloon Counterpulsation and Streptokinase in Acute Anterior Myocardial Infarction Angiology, June 1, 1999; 50(6): 465 - 471. [Abstract] [PDF]
|
|
|
|
|
|
A.W.J. van 't Hof, A.L. Liem, M.J. de Boer, J.C.A. Hoorntje, H. Suryapranata, and F. Zijlstra A randomized comparison of intra-aortic balloon pumping after primary coronary angioplasty in high risk patients with acute myocardial infarction Eur. Heart J., May 1, 1999; 20(9): 659 - 665. [Abstract] [PDF]
|
|
|
|
|
|
R. Gitter, C. M. Cate, K. Smart, and G. K. Jett Influence of Ascending Versus Descending Balloon Counterpulsation on Bypass Graft Blood Flow Ann. Thorac. Surg., February 1, 1998; 65(2): 365 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. N. Nanas, S. N. Nanas, D. A. Kontoyannis, K. S. Moussoutzani, J. P. Hatzigeorgiou, P. B. Heras, K. P. Makaritsis, E. B. Agapitos, and S. D. Moulopoulos Myocardial Salvage by the Use of Reperfusion and Intraaortic Balloon Pump: Experimental Study Ann. Thorac. Surg., February 1, 1996; 61(2): 629 - 634. [Abstract] [Full Text]
|
|