Portal de Periódicos da CAPES

Experience from a randomized controlled trial with Impella 2.5 versus IABP in STEMI patients with cardiogenic pre-shock.

2015; Elsevier BV; Volume: 202; Linguagem: Inglês

10.1016/j.ijcard.2015.10.063

1874-1754

Dagmar M. Ouweneel, Annemarie E. Engström, Krischan D. Sjauw, Alexander Hirsch, Jonathan Hill, B. Gockel, Vegard Tuseth, René J. van der Schaaf, José P.S. Henriques,

Cardiac Structural Anomalies and Repair

Cardiogenic shock occurs in approximately 6–10% of patients with acute ST-segment elevation myocardial infarction (STEMI) [ [1] Goldberg R.J. Spencer F.A. Gore J.M. Lessard D. Yarzebski J. Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: a population-based perspective. Circulation. 2009; 119: 1211-1219 Crossref PubMed Scopus (498) Google Scholar ]. Anterior STEMI patients with high heart rate or low systolic blood pressure may qualify as pre-shock patients and until recently these patients were frequently supported with an intra-aortic balloon pump (IABP). However, routine usage of the IABP patients with anterior STEMI and cardiogenic shock is not associated with clinical benefit and is no longer recommended [ 2 Thiele H. Zeymer U. Neumann F.J. Ferenc M. Olbrich H.G. Hausleiter J. et al. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet. 2013; 382: 1638-1645 Abstract Full Text Full Text PDF PubMed Scopus (630) Google Scholar , 3 Sjauw K.D. Engstrom A.E. Vis M.M. van der Schaaf R.J. Baan Jr., J. Koch K.T. et al. 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. 2009; 30: 459-468 Crossref PubMed Scopus (472) Google Scholar , 4 Windecker S. Kolh P. Alfonso F. Collet J.P. Cremer J. Falk V. et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur. Heart J. 2014; 35: 2541-2619 Crossref PubMed Scopus (3892) Google Scholar ]. Therefore, research is currently directed at potentially more powerful devices for percutaneous mechanical circulatory support [ [5] Ouweneel D.M. Henriques J.P. Percutaneous cardiac support devices for cardiogenic shock: current indications and recommendations. Heart. 2012; 98: 1246-1254 Crossref PubMed Scopus (55) Google Scholar ]. However, evidence from randomized controlled trials is scarce, as this patient population is difficult to identify and study.