Use of Intra-aortic Balloon Pump Before Surgery for Acute Myocardial Infarction

Ataturk University

Status: Completed

Conditions: Coronary Bypass Graft Stenosis of Autologous Vessel; Coronary Artery Disease; Troponin; IABP - Disorder of Intra-Aortic Balloon Pump; Acute Myocardial Infarction

Treatments: Device: Intra-aortic Balloon Pump

Study type: Interventional

Funder types: Other

Identifiers

NCT06468982

AÜ-CVS-UA-01

Details and patient eligibility

About

The optimal timing of surgery in patients with acute myocardial infarction (AMI) and the utilization of preoperative intra-aortic balloon pumps (IABP) in these patients are subjects of ongoing discussion and disagreement. This study aimed to investigate the effects of preoperative IABP on troponin levels, surgical timing, and intraoperative and postoperative outcomes for patients with AMI who undergo coronary artery bypass grafting (CABG).

Full description

Percutaneous coronary intervention (PCI) is the first treatment for myocardial ischemia; however, if left main coronary artery disease, multivessel disease, or complex architecture disable PCI, 10% of patients may need coronary artery bypass grafting (CABG). Abstinence from surgical reperfusion in patients with acute myocardial infarction (AMI) may be justified due to surgery's 50% mortality rate. An intra-aortic balloon pump (IABP) can help patients who have ongoing ischemia and high cardiac enzymes because it changes the way the heart uses oxygen by increasing coronary blood flow and lowering afterload. Some guidelines do not recommend the use of IABP in patients with AMI except for mechanical complications or shock. Nevertheless, it is commonly acknowledged that the specific criteria for employing IABP differ among clinics and are determined by clinical expertise. Patients with AMI who have impaired coronary perfusion and require surgical revascularization can benefit from preoperative intra-aortic balloon pump (IABP) support. This intervention leads to reorganization of coronary perfusion, resulting in a decrease in elevated troponin levels and quicker myocardial recovery.

Enrollment: 156 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients who have had acute myocardial infarction and have been decided on coronary surgical revascularization

Exclusion criteria

• mechanical complications of Acute Myocardial Infarction (such as a ruptured chordal or ventricular septum)
• peripheral arterial disease
• renal failure
• history of cerebrovascular accident
• acute cardiogenic shock and cardiac arrest
• reoperation and combined operations

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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156 participants in 2 patient groups

Group A (IABP support)

Active Comparator group

Description:

Patients who are receiving intra-aortic balloon pump support during the preoperative period

Treatment:

Device: Intra-aortic Balloon Pump

Group B (control group; without IABP support)

No Intervention group

Description:

Patients who did not receive intra-aortic balloon pump support in the preoperative period; control group