Clinical impact of intra-aortic balloon pump during extracorporeal membrane oxygenation in patients with acute myocardial infarction complicated by cardiogenic shock

Introduction: There is no available data on the clinical outcome in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock supported by intra-aortic balloon pump (IABP), in combination with extracorporeal membrane oxygenation (ECMO). Methods: We analyzed 96 consecutive patients with AMI and complicating cardiogenic shock, assisted by ECMO system between January 2004 and December 2011. The primary outcome was in-hospital mortality. The secondary outcomes were the success rate of weaning from ECMO and the lactate clearance for 48 hours (%). Results: A combination of IABP and ECMO was performed on 41 (42.7%) patients. Inhospital mortality occurred for 51 patients (ECMO with IABP versus ECMO alone; 51.2% vs. 54.5%, P = 0.747). The success rate of weaning from ECMO was also similar between the two groups (63.4% vs. 58.2%, P = 0.604). Complications such as ischemia of a lower extremity or bleeding at the ECMO insertion site did not increase in cases of ECMO with IABP (P = 0.521 and P = 0.667, respectively). Among patients who survived for 24 hours after intervention, lactate clearance was not significantly different between the patients who received ECMO alone and those who had ECMO with IABP (P = 0.918). Conclusions: The combined use of ECMO and IABP did not improve in-hospital survival in patients with AMI complicated by cardiogenic shock.