Cardiogenic shock remains a leading cause of death in AMI. The incidence occurs in about 5 - 8% of patients hospitalized with STEMI and has a mortality rate of about 50%. The strategy to stabilize with IABP, treat with reperfusion, and transfer for complete revascularization has thus far yielded the best outcomes and every effort should be made to implement this strategy.1
Current ACC/AHA Guidelines stress the importance stabilizing patients in cardiogenic shock with IABP therapy prior to PCI. It is important to note that patients receiving IABP therapy may be excluded from the Doot-to-Balloon (D2B) time quality measurement metric.
IABP in Cardiogenic Shock:
1 Cardiogenic shock current concepts and improving outcomes. H R Reynolds et al. Circulation 2008 ;117 :686-697
2 Usefulness of IABP counterpulsation in patients with cardiogenic shock from AMI. J M Cheng et al. Am J Cardiol 2009;104:327-332
3 A Prospective Feasibility Trial Investigating the Impella 2.5 System in Patients Undergoing High-Risk PCI. S R Dixon JACC 2009;2:91-6
4 M Abdel-Wahab, et al. Am J Cardiol 2010;105:967-971