Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study shows balloon pump use prior to angioplasty does not reduce heart muscle damage

30.08.2011
Inserting intra-aortic balloon pumps prior to angioplasty in patients with acute myocardial infarction (AMI) does not reduce the scope of heart muscle damage, a condition referred to as infarct size, according to a new study conducted by Duke University Medical Center researchers.

The findings were published online today in the Journal of the American Medical Association (JAMA), and presented at the European Society of Cardiology in Paris, France.

The intra-aortic balloon pump works by increasing the blood supply to the heart, which reduces the heart's workload. According to Manesh Patel, M.D., the principal investigator and cardiologist at the Duke Clinical Research Institute (DCRI), "animal studies had suggested that inserting a balloon pump before opening the vessel would reduce the heart's workload and by doing so, could potentially reduce infarct size When we tested this observation in humans, we did not show an infarct reduction."

CRISP AMI was a multi-center, prospective, randomized trial that enrolled patients with acute ST-segment elevation myocardial infarction (STEMI) without shock within six hours of chest pain onset and planned primary percutaneous coronary intervention (PCI). Of the 337 patients enrolled, 161 were randomized to receive intra-aortic balloon counterpulsation (IABC) prior to primary PCI, and 176 to the standard of care (SOC), which is primary PCI without IABC support.

The mean infarct size, measured using cardiac magnetic resonance imaging, was not significantly different between the IABC and SOC groups (42.1% vs. 37.5%). At 30 days, major bleeding or transfusion occurred in 5 (3.1%) of the IABC patients versus 3 (1.7%) of SOC patients. Major vascular complications occurred in 7 (4.3%) of the IABC patients, versus 2 (1.1%) of the SOC patients. treated with IABC compared to SOC. By six months, death occurred in 3 (1.9%) in the IABC group and 9 (5.2%) in the SOC group.

While the study was not set up to report clinical events, the researchers say the results are interesting because they offer unique insight into treating AMI patients.

"The most striking observation is the excellent overall outcome for the highest-risk patients within the context of this trial," says E. Magnus Ohman, M.D., a co-investigator and cardiologist at DCRI. "The IABC group had less than five percent mortality. It's hard to improve that. We've gotten very good at treating AMI patients."

Acute myocardial infarction patients represent nearly half of the approximately 1.5 million annual hospitalizations for acute coronary syndromes in the U.S. Acute mortality risk is between 6% and 15%; one-year mortality is estimated at 38% for women and 25% for men.

Ohman says it's also important to note that 15 of the patients in the standard of care group crossed over to receive IABC – five prior to PCI and 10 after.

"While routine use of IABC is not recommended, physicians should be vigilant about identifying patients who are at risk for rapid deterioration and may benefit from counterpulsation," says Patel.

Funding for CRISP AMI was provided by Maquet/Datascope.

Manesh Patel, M.D., receives research grants and support from Maquet/Datascope.

Co-authors of this paper include Richard W. Smalling, M.D. Ph.D, Memorial Hermann Heart and Vascular Institute, University of Texas, Houston, TX;Holger Thiele, M.D., University of Leipzig-Heart Center, Leipzig, Germany; Huiman X. Barnhart, Ph.D. and Yi Zhou, Ph.D, DCRI; Praveen Chandra, M.D., Medanta–The Medicity, Haryana, India; Derek Chew, M.D., Flinders Medical Center, Bedford Park, Australia; Marc Cohen, M.D., Newark Beth Israel Medical Center, Newark, NJ; John French, MB, CHB, Ph.D., Liverpool Hospital, Liverpool, Australia; and Divaka Perera, M.D., Kings College, London, UK.

Debbe Geiger | EurekAlert!
Further information:
http://www.duke.edu

More articles from Medical Engineering:

nachricht Novel breast tomosynthesis technique reduces screening recall rate
21.02.2017 | Radiological Society of North America

nachricht Biocompatible 3-D tracking system has potential to improve robot-assisted surgery
17.02.2017 | Children's National Health System

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Impacts of mass coral die-off on Indian Ocean reefs revealed

21.02.2017 | Earth Sciences

Novel breast tomosynthesis technique reduces screening recall rate

21.02.2017 | Medical Engineering

Use your Voice – and Smart Homes will “LISTEN”

21.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>