IABP-SHOCK II Trial - Kardio.hr

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Randomized Studies in Cardiogenic Shock Trial Follow-up n/N n/N Revascularization (PCI/CABG) SHOCK SMASH Total Catecholamines SOAP II (CS Subgroup) Glycoprotein IIb/IIIa-Inhibitors PRAGUE-7 NO Synthase Inhibitors TRIUMPH SHOCK-2 Cotter et al Total IABP IABP-SHOCK I IABP-SHOCK II Total LVAD Thiele et al Burkhoff et al Seyfarth et al Total 1-year 30 days 28 days 76/152 22/32 103/184 83/149 18/23 117/172 64/145 50/135 Early revascularization better Norepinephrine better Relative Risk 95% CI Medical treatment better Dopamine better 0 0.25 0.5 0.75 1 1.5 2 2.5 3 Relative Risk 95% CI 0.80 (0.66;0.98) 0.87 (0.66;1.29) 0.82 (0.70;0.98) 0.75 (0.55;0.93) In-hospital 15/40 13/40 1.15 (0.59;2.27) 30 days 30 days 30 days 30 days 30 days 30 days 30 days 30 days 97/201 24/59 4/15 125/275 7/19 119/300 126/319 9/21 9/19 6/13 24/53 76/180 7/20 10/15 93/215 6/21 123/298 129/319 IABP 9/20 5/14 6/13 20/47 Up-stream Abciximab better NO Synthase inhibition better better LVAD better Standard treatment better Placebo better Standard treatment better IABP better 1.14 (0.91;1.45) 1.16 (0.59;2.69) 0.40 (0.13;1.05) 1.05 (0.85;1.29) 1.28 (0.45;3.72) 0.96 (0.79;1.17) 0.98 (0.81;1.18) 0.95 (0.48;1.90) 1.33 (0.57-3.10) 1.00 (0.44-2.29) 1.06 (0.68-1.66) Updated from Thiele et al. Eur Heart J 2010,31:1828-1835
Summary + Conclusions • IABP support in cardiogenic shock is safe without significant inherent complications. • However, IABP support did not reduce 30-day mortality in this large, randomized, multicenter trial in cardiogenic shock patients complicating myocardial infarction undergoing early revascularization. • The primary study endpoint results are supported by a lack of benefit in secondary endpoints.
Page 1 and 2: Randomized comparison of intraaorti
Page 3 and 4: Background IABP in Cardiogenic Shoc
Page 5 and 6: Background Mortality IABP vs no IAB
Page 7 and 8: Methods Study Sites and Organisatio
Page 9 and 10: Methods Statistical Methodology Sam
Page 11 and 12: Results Age (years); median (IQR) M
Page 13 and 14: Results Simplified Acute Physiology
Page 15 and 16: Results Serum Lactate (mmol/l) 9 8
Page 17 and 18: Results Primary Study Endpoint (30-
Page 19: Results Safety IABP (n=300) Control
Page 23: www.nejm.org

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