Abstract

Objectives: To assess the outcomes of elderly (age ≥ 65 years) patients supported by intra-aortic balloon pumping (IABP) for ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS).

Background: The effectiveness of IABP in patients with acutemyocardial infarction complicated by CS is unclear, as fewIABP trials have included elderly STEMI patients. Therefore, studies investigating the use of IABP for CS during primary percutaneous coronary intervention (PCI) and associated outcomes in patients aged ≥ 65 years with STEMI are needed.

Methods: We studied 169 STEMI patients with CS who received primary PCI between January 2012 and December 2015. Based on age and the presence of IABP, the patients were classified into three groups; those ≥ 65 years with or without IABP, and those < 65 years with IABP. The mortality rates and risk factors for mortality were analyzed.

Results: IABP supported 102 of the patients (60.4%) regardless of age. Of these patients, 49% were ≥ 65 years old, and they were more likely to have left main disease (26% vs. 6.9%, p = 0.037) and decompensated heart failure. There was no significant difference in in-hospital mortality between the two elderly groups (40% vs. 20.69%, p = 0.97). The in-hospital mortality rate in the elderly group was insignificantly higher than that in the younger group (40% vs. 26.92%, p = 0.39).

Conclusions: Regardless of age, the use of IABP did not affect the in-hospital mortality rate in the patients with STEMI and CS undergoing primary PCI. Systolic blood pressure and door to first balloon inflation time were independent predictors of in-hospital mortality.