Post MI Cardiogenic Shock 환자에서 조기 IABP 및 Reperfusion Therapy의 효과

Abstract

Background: We sought to examine the use and outcomes with early intraaortic balloon couterpulsation(IABP) combined early reperfusion therapy in patients presenting with cardiogenic shock complicating acute myocardial infarction. The use of IABP in patients with cardiogenic shock is widely accepted. however, there is a paucity of information on the use of this technique in patients with cardiogenic shock who are treated with reperfusion therapy in Korea. Materials and Methods: Twenty-eight Patients presented with cardiogenic shock were classified into two groups: the early IABP group (insertion within 12 hours after AMI onset time) and late IABP group (insertion after 12 hours). We compared In-hospital mortality in two group (early IABP group vs late IABP group). Results: Two groups show no significant difference at clinical feature and coronary angiographic results. Among total 28 patients, 7 patients were treated with thrombolytic therapy and 21 patients with PTCA. Insertion site bleeding, fever, thrombocytopenia were reported as some of the complications of IABP insertion. In-hospital mortality of early IABP group and late IABP group were 4 patients(25%) and 8 patients(66%), respectively(p<0.05). Early IABP insertion and early PTCA showed lower hospital mortality rates. There was significant difference in the time to PTCA after AMI onset between the to groups(p<0.05). Conclusion: IABP appears to be useful in patients presenting with cardiogenic shock unresponsive medical therapy. Early IABP insertion and early Reperfusion therapy may reduce In-hospital mortality rates in PostMI Cardiogenic shock patients.