Study objectives
Between March 2017 and June 2018, a retrospective study enrolled 306 patients with AMI complicating pump failure who undergo coronary artery angiography (CAG) or PCI was conducted. Patients were divided into the duration ≤4 days and the duration>4 days in the basis of median of the IABP duration. This study was approved by the hospital research ethics committee.
Patients of ≥18 years diagnosed as with AMI (STEMI or NSTEMI) complicating pump failure were eligible for the study. Diagnostic criteria for AMI, referring to the 2015 European Society of Cardiology guidelines for the management of non-ST-segment elevation acute coronary syndromes (ACS)7 ,were established as follows: An increase in cardiac biomarkers (e.g. serum troponin) above 99% of the upper limit of reference values plus two or more of the following evidence of myocardial ischemia including (1) clinical symptoms of myocardial ischemia; (2) new electrocardiographic changes of myocardial ischemia (i.e. new ST-segment changes or new left bundle-branch block); (3)new pathological Q waves appearing in electrocardiogram; (4) radiographic evidence of new cardiac function loss or segmental ventricular motion abnormalities.
The diagnostic criteria were required for pump failure as follows: (1) AMI associated with acute pulmonary edema performance, or both audible lung sounds (dry or wet) with a range of > 50% of the lung field; (2) Systolic blood pressure (SBP )< 90mmHg and/or diastolic blood pressure (DBP) < 60mmHg, or mean arterial pressure (MBP) <70mmHg; (3) peripheral circulatory failure such as oliguria, anorexia limbs, etc.
Exclusion criteria included: (1) statin intake within 1 month; (2) contrast agent using within 2 weeks; (3) severe renal dysfunction (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m2) (4) any mechanical complications of AMI such as left ventricular free wall rupture, interventricular septum perforation, papillary muscle rupture; (5) severe aortic valve insufficiency, abdominal aorta or aortic aneurysm, aortic dissection.