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.