Application of emergency intra-aortic balloon pump counter pulsation in elderly patients with acute myocardial infarction combined with cardiogenic shock / 中华老年医学杂志

ABSTRACT

Objective To evaluate the efficacy of intra-aortic balloon pump (IABP) on elderly patients with acute myocardial infarction (AMI) combined with cardiogenic shock (CS).Methods Among 62 elderly patients with AMI plus CS undergoing percutaneous coronary intervention (PCI),32 patients received IABP before PCI (IABP group) and 30 patients did not (control group).Diastolic blood press ure(DBP),mean arterial pressure (MAP),heart rate,cardiac index (CI),and ejective fraction before and 2 weeks after PCI in the two groups were observed.The short-and long-term therapeutic effects were compared between the two groups.Results The DBP,MAP and CI were higher and heart rate was lower in IABP group than in control group within 24 h after IABP [(64.4± 11.1) mmHg vs.(37.8±15.1) mmHg,(71.4±8.3) mmHg vs.(43.0±10.5) mmHg,(2.98± 0.33) L· min-1 · m-2 vs.(1.99±0.29) L· min-1 · m-2,(90.7±18.7) /min vs.(130.2±50.1)/min,t=7.97,11.83,12.51,4.16,all P=0.000].Two weeks after IABP,LVEF was significantly improved in IABP and control groups as compared with pre-IABP [(46.4±7.2)％ vs.(35.2± 7.2) ％,(39.1±6.8) ％ vs.(33.8±6.7) ％,both P＜0.01],and heart function was improved more significantly in IABP group than in the control group (t=3.91,P=0.000).Death tolls during hospitalization and after leaving hospital,and recurrence of AMI had no significant differences between the two groups (2 cases vs.4 cases,3 cases vs.8 cases,6 cases vs.10 cases,x2 =0.89,3.17,1.72,P=0.346,0.075,0.190).Conclusions IABP can improve the cardiac function in elderly AMI patients with CS after PCI.