Intra-aortic balloon pump counterpulsation in extensive myocardial infarction with persistent ischemia: the SEMPER FI pilot study

Lokien X. van Nunen (Corresponding author), Marcel van ’t Veer, Frederik M. Zimmermann, Inge Wijnbergen, Guus R.G. Brueren, Pim A.L. Tonino, Wilbert A. Aarnoudse, Nico H.J. Pijls

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2 Citaties (Scopus)

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Objectives: This study aimed to prospectively investigate intra-aortic balloon pump counterpulsation (IABP) support in large myocardial infarction complicated by persistent ischemia after primary percutaneous coronary intervention (PCI). Background: Use of IABP is suggested to be effective by increasing diastolic aortic pressure, thereby improving coronary blood flow. This can only be expected with exhausted coronary autoregulation, typical in acute myocardial infarction complicated by persistent ischemia. In this situation, augmented diastolic pressure is expected to increase myocardial oxygenation. Methods: One hundred patients with large STEMI complicated by persistent ischemia after primary PCI were randomized to treatment with or without IABP therapy on top of standard care. IABP support was initiated following primary PCI, immediately after inclusion. Primary end point was all-cause mortality, need for (additional) mechanical hemodynamic support, or readmission for heart failure within 6 months. Results: Mean age was 63 ± 10 years, 76% were male. Mean systolic and diastolic blood pressure were 120 ± 25 mmHg and 73 ± 17 mmHg. Mean heart rate was 75 ± 18 mmHg. Before PCI, mean summed ST-deviation was 21 ± 8 mm with only minimal ST-resolution after PCI. One patient in the IABP group reached the primary end point versus four patients in the control group (2% vs. 8%; p = 0.16). After primary PCI, resolution of ST-deviation was significantly more pronounced in the IABP group (73 ± 17%) compared to the control group (56 ± 26%; p < 0.01). Conclusions: In this pilot study, in patients with large STEMI and persistent ischemia after primary PCI, use of IABP showed a nonsignificant decrease in mortality, necessity for (additional) mechanical hemodynamic support or readmission for heart failure at 6 months, and resulted in more rapid ST-resolution.

Originele taal-2Engels
Pagina's (van-tot)128-135
Aantal pagina's8
TijdschriftCatheterization and Cardiovascular Interventions
Volume95
Nummer van het tijdschrift1
Vroegere onlinedatum24 apr 2019
DOI's
StatusGepubliceerd - jan 2020

Vingerafdruk

Counterpulsation
Percutaneous Coronary Intervention
Ischemia
Myocardial Infarction
Blood Pressure
Heart Failure
Hemodynamics
Control Groups
Mortality
Standard of Care
Arterial Pressure
Homeostasis
Heart Rate
Therapeutics

Citeer dit

van Nunen, Lokien X. ; van ’t Veer, Marcel ; Zimmermann, Frederik M. ; Wijnbergen, Inge ; Brueren, Guus R.G. ; Tonino, Pim A.L. ; Aarnoudse, Wilbert A. ; Pijls, Nico H.J. / Intra-aortic balloon pump counterpulsation in extensive myocardial infarction with persistent ischemia : the SEMPER FI pilot study. In: Catheterization and Cardiovascular Interventions. 2020 ; Vol. 95, Nr. 1. blz. 128-135.
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title = "Intra-aortic balloon pump counterpulsation in extensive myocardial infarction with persistent ischemia: the SEMPER FI pilot study",
abstract = "Objectives: This study aimed to prospectively investigate intra-aortic balloon pump counterpulsation (IABP) support in large myocardial infarction complicated by persistent ischemia after primary percutaneous coronary intervention (PCI). Background: Use of IABP is suggested to be effective by increasing diastolic aortic pressure, thereby improving coronary blood flow. This can only be expected with exhausted coronary autoregulation, typical in acute myocardial infarction complicated by persistent ischemia. In this situation, augmented diastolic pressure is expected to increase myocardial oxygenation. Methods: One hundred patients with large STEMI complicated by persistent ischemia after primary PCI were randomized to treatment with or without IABP therapy on top of standard care. IABP support was initiated following primary PCI, immediately after inclusion. Primary end point was all-cause mortality, need for (additional) mechanical hemodynamic support, or readmission for heart failure within 6 months. Results: Mean age was 63 ± 10 years, 76{\%} were male. Mean systolic and diastolic blood pressure were 120 ± 25 mmHg and 73 ± 17 mmHg. Mean heart rate was 75 ± 18 mmHg. Before PCI, mean summed ST-deviation was 21 ± 8 mm with only minimal ST-resolution after PCI. One patient in the IABP group reached the primary end point versus four patients in the control group (2{\%} vs. 8{\%}; p = 0.16). After primary PCI, resolution of ST-deviation was significantly more pronounced in the IABP group (73 ± 17{\%}) compared to the control group (56 ± 26{\%}; p < 0.01). Conclusions: In this pilot study, in patients with large STEMI and persistent ischemia after primary PCI, use of IABP showed a nonsignificant decrease in mortality, necessity for (additional) mechanical hemodynamic support or readmission for heart failure at 6 months, and resulted in more rapid ST-resolution.",
keywords = "coronary autoregulation, intra-aortic balloon pump, myocardial infarction, percutaneous coronary intervention, persistent ischemia",
author = "{van Nunen}, {Lokien X.} and {van ’t Veer}, Marcel and Zimmermann, {Frederik M.} and Inge Wijnbergen and Brueren, {Guus R.G.} and Tonino, {Pim A.L.} and Aarnoudse, {Wilbert A.} and Pijls, {Nico H.J.}",
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journal = "Catheterization and Cardiovascular Interventions",
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Intra-aortic balloon pump counterpulsation in extensive myocardial infarction with persistent ischemia : the SEMPER FI pilot study. / van Nunen, Lokien X. (Corresponding author); van ’t Veer, Marcel; Zimmermann, Frederik M.; Wijnbergen, Inge; Brueren, Guus R.G.; Tonino, Pim A.L.; Aarnoudse, Wilbert A.; Pijls, Nico H.J.

In: Catheterization and Cardiovascular Interventions, Vol. 95, Nr. 1, 01.2020, blz. 128-135.

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

TY - JOUR

T1 - Intra-aortic balloon pump counterpulsation in extensive myocardial infarction with persistent ischemia

T2 - the SEMPER FI pilot study

AU - van Nunen, Lokien X.

AU - van ’t Veer, Marcel

AU - Zimmermann, Frederik M.

AU - Wijnbergen, Inge

AU - Brueren, Guus R.G.

AU - Tonino, Pim A.L.

AU - Aarnoudse, Wilbert A.

AU - Pijls, Nico H.J.

PY - 2020/1

Y1 - 2020/1

N2 - Objectives: This study aimed to prospectively investigate intra-aortic balloon pump counterpulsation (IABP) support in large myocardial infarction complicated by persistent ischemia after primary percutaneous coronary intervention (PCI). Background: Use of IABP is suggested to be effective by increasing diastolic aortic pressure, thereby improving coronary blood flow. This can only be expected with exhausted coronary autoregulation, typical in acute myocardial infarction complicated by persistent ischemia. In this situation, augmented diastolic pressure is expected to increase myocardial oxygenation. Methods: One hundred patients with large STEMI complicated by persistent ischemia after primary PCI were randomized to treatment with or without IABP therapy on top of standard care. IABP support was initiated following primary PCI, immediately after inclusion. Primary end point was all-cause mortality, need for (additional) mechanical hemodynamic support, or readmission for heart failure within 6 months. Results: Mean age was 63 ± 10 years, 76% were male. Mean systolic and diastolic blood pressure were 120 ± 25 mmHg and 73 ± 17 mmHg. Mean heart rate was 75 ± 18 mmHg. Before PCI, mean summed ST-deviation was 21 ± 8 mm with only minimal ST-resolution after PCI. One patient in the IABP group reached the primary end point versus four patients in the control group (2% vs. 8%; p = 0.16). After primary PCI, resolution of ST-deviation was significantly more pronounced in the IABP group (73 ± 17%) compared to the control group (56 ± 26%; p < 0.01). Conclusions: In this pilot study, in patients with large STEMI and persistent ischemia after primary PCI, use of IABP showed a nonsignificant decrease in mortality, necessity for (additional) mechanical hemodynamic support or readmission for heart failure at 6 months, and resulted in more rapid ST-resolution.

AB - Objectives: This study aimed to prospectively investigate intra-aortic balloon pump counterpulsation (IABP) support in large myocardial infarction complicated by persistent ischemia after primary percutaneous coronary intervention (PCI). Background: Use of IABP is suggested to be effective by increasing diastolic aortic pressure, thereby improving coronary blood flow. This can only be expected with exhausted coronary autoregulation, typical in acute myocardial infarction complicated by persistent ischemia. In this situation, augmented diastolic pressure is expected to increase myocardial oxygenation. Methods: One hundred patients with large STEMI complicated by persistent ischemia after primary PCI were randomized to treatment with or without IABP therapy on top of standard care. IABP support was initiated following primary PCI, immediately after inclusion. Primary end point was all-cause mortality, need for (additional) mechanical hemodynamic support, or readmission for heart failure within 6 months. Results: Mean age was 63 ± 10 years, 76% were male. Mean systolic and diastolic blood pressure were 120 ± 25 mmHg and 73 ± 17 mmHg. Mean heart rate was 75 ± 18 mmHg. Before PCI, mean summed ST-deviation was 21 ± 8 mm with only minimal ST-resolution after PCI. One patient in the IABP group reached the primary end point versus four patients in the control group (2% vs. 8%; p = 0.16). After primary PCI, resolution of ST-deviation was significantly more pronounced in the IABP group (73 ± 17%) compared to the control group (56 ± 26%; p < 0.01). Conclusions: In this pilot study, in patients with large STEMI and persistent ischemia after primary PCI, use of IABP showed a nonsignificant decrease in mortality, necessity for (additional) mechanical hemodynamic support or readmission for heart failure at 6 months, and resulted in more rapid ST-resolution.

KW - coronary autoregulation

KW - intra-aortic balloon pump

KW - myocardial infarction

KW - percutaneous coronary intervention

KW - persistent ischemia

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U2 - 10.1002/ccd.28289

DO - 10.1002/ccd.28289

M3 - Article

C2 - 31020797

AN - SCOPUS:85065131843

VL - 95

SP - 128

EP - 135

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 1

ER -