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of patients with MI complicated by cardiogenic shock<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> that assessed the use of IABP compared to non-IABP treatment including other ventricular assist devices&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Searches of the Cochrane Central Register of Controlled Trials &#40;CENTRAL&#41;&#44; MEDLINE&#44; EMBASE&#44; LILACS&#44; IndMed&#44; KoreaMed&#44; and registers of ongoing trials were performed in October 2013&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Data were pooled in meta-analyses&#46; Hazard ratios &#40;HR&#41; with 95&#37; confidence intervals &#40;CI&#41; were used to express time-related variables such as time to event and dichotomous variables were expressed as odds ratios &#40;OR&#41; with 95&#37; CI&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">Seven trials were included&#44; with a total of 790 patients &#40;406 in the intervention groups and 384 in the control groups&#41;&#46; Four trials compared IABP to standard therapy and three to other left ventricular assist devices &#40;two with the TandemHeart<span class="elsevierStyleSup">&#174;</span> and one with the Impella<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">None of the trials were blinded to treatment allocation&#46; All patients were revascularized&#44; 95&#37; by primary angioplasty and 5&#37; by fibrinolysis&#46; Mean time of IABP support was 59 hours&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The proportion of fatal events at 30 days was around 40&#37;&#46; Aggregate analysis of the trials provided no evidence for a beneficial effect of IABP on mortality 30 days after the index event &#40;HR 0&#46;95&#59; 95&#37; CI 0&#46;76&#8211;1&#46;19&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; Six-month mortality was also similar to other treatment strategies &#40;OR 0&#46;96&#59; 95&#37; CI 0&#46;71&#8211;1&#46;30&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">During hospitalization&#44; 15 &#40;4&#46;12&#37;&#41; out of 364 patients from the intervention groups suffered severe adverse events &#40;reinfarction or stroke&#41;&#44; compared to five &#40;1&#46;38&#37;&#41; out of 363 from the control groups&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Available evidence&#44; based on RCTs&#44; does not support the systematic use of IABP in patients with cardiogenic shock secondary to MI to improve survival&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Comment</span><p id="par0065" class="elsevierStylePara elsevierViewall">Cardiogenic shock is a complication of MI in 5&#8211;7&#37; of cases and is associated with high mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> There is little evidence concerning treatment of this extremely serious condition&#59; only coronary revascularization has been shown to reduce mortality significantly at six months&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The physiological basis for inflation of an IABP in the thoracic aorta in diastole is that it will improve certain hemodynamic parameters that affect prognosis&#44; particularly by enhancing coronary flow&#44; reducing afterload and increasing the cardiac index&#46; As with any medical intervention&#44; its systematic use must be based on methodologically robust studies&#46; In this review&#44; IABP did not reduce mortality in either the short or long term in the pooled analysis of RCTs&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#44;4</span></a> With regard to the adverse events most often associated with IABP &#40;stroke&#44; peripheral ischemic vascular complications&#44; bleeding and sepsis&#41;&#44; the most robust study &#40;IABP-SHOCK II&#41; showed no significant differences between IABP and medical therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">It should be borne in mind that the overall assessment of the impact of IABP in this systematic review is limited by certain factors&#44; including the lack of blinding to treatment allocation&#44; the inclusion of trials with small study populations and high crossover rates&#44; and the inclusion of patients with IABP at randomization&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Clinical implications</span><p id="par0080" class="elsevierStylePara elsevierViewall">The European Society of Cardiology guidelines for the management of MI with ST-segment elevation state that IABP may be considered &#40;class of recommendation IIb&#44; level of evidence B&#41; in patients with MI complicated by cardiogenic shock&#44; while other ventricular assist devices have the same class of recommendation &#40;IIb&#41; but a lower level of evidence &#40;C&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The American College of Cardiology Foundation&#47;American Heart Association guidelines for the management of heart failure give class of recommendation IIa&#44; level of evidence B&#44; for ventricular assist devices in patients with MI and cardiogenic shock refractory to medical therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">IABP thus has only a secondary role in the treatment of MI-related cardiogenic shock&#44; and its routine use is not recommended&#44; since the intervention does not lead to clear benefits&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ethical disclosures</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Protection of human and animal subjects</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Confidentiality of data</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Right to privacy and informed consent</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Improvement of hemodynamic parameters is the rationale for the use of intra-aortic balloon pump counterpulsation &#40;IABP&#41; in patients with cardiogenic shock following acute myocardial infarction &#40;MI&#41;&#46; This Cochrane systematic review evaluated the impact of this intervention in reducing mortality&#46; Seven randomized controlled trials with a total of 790 patients were included &#40;four using medical therapy as a comparator&#44; and three comparing IABP with other ventricular assist devices&#41;&#46; IABP did not reduce mortality in either the short or long term&#46; Therefore&#44; the systematic use of IABP in patients with cardiogenic shock following MI cannot be recommended&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A melhoria de par&#226;metros hemodin&#226;micos justifica o uso do bal&#227;o intra-a&#243;rtico &#40;BIA&#41; em doentes com enfarte agudo do mioc&#225;rdio &#40;EAM&#41; complicado por choque cardiog&#233;nico&#46; Esta revis&#227;o sistem&#225;tica da <span class="elsevierStyleItalic">Cochrane</span> avaliou o potencial impacto desta interven&#231;&#227;o na mortalidade&#46; Foram avaliados sete ensaios cl&#237;nicos aleatorizados e controlados com um total de 790 doentes &#40;quatro estudos utilizando a terap&#234;utica m&#233;dica como comparador e tr&#234;s estudos compararam o BIA com outros dispositivos de assist&#234;ncia ventricular&#41;&#46; O uso de BIA n&#227;o reduziu significativamente a mortalidade a curto ou a longo prazo nos doentes com EAM e choque cardiog&#233;nico&#46; N&#227;o existe evid&#234;ncia que suporte o seu uso sistem&#225;tico nestes doentes&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">30-day mortality with IABP &#40;adapted from Unverzagt et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a>&#41;&#46; CI&#58; confidence interval&#59; HR&#58; hazard ratio&#59; IABP&#58; intra-aortic balloon pump counterpulsation&#59; RCTs&#58; randomized controlled trials&#59; VADs&#58; ventricular assist devices&#46;</p>"
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                      "titulo" => "Intra-aortic balloon pump counterpulsation &#40;IABP&#41; for myocardial infarction complicated by cardiogenic shock"
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                          "etal" => true
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                            2 => "A&#46; de Waha"
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                        "paginaInicial" => "CD007398"
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            1 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "2"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Thirty-year trends &#40;1975 to 2005&#41; in the magnitude of&#44; management of&#44; and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction&#58; a population-based perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;J&#46; Goldberg"
                            1 => "F&#46;A&#46; Spencer"
                            2 => "J&#46;M&#46; Gore"
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.108.814947"
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                        "tituloSerie" => "Circulation"
                        "fecha" => "2009"
                        "volumen" => "119"
                        "paginaInicial" => "1211"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19237658"
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              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
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                      "titulo" => "Early revascularization in acute myocardial infarction complicated by cardiogenic shock&#46; SHOCK Investigators&#46; Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock"
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                        0 => array:2 [
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                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Hochman"
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                            2 => "J&#46;G&#46; Webb"
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                    0 => array:2 [
                      "doi" => "10.1056/NEJM199908263410901"
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                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1999"
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                      "titulo" => "Intraaortic balloon pump in cardiogenic shock II &#40;IABP-SHOCK II&#41; trial investigators&#46; Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock &#40;IABP-SHOCK II&#41;&#58; final 12 month results of a randomised&#44; open-label trial"
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                      "doi" => "10.1016/S0140-6736(13)61783-3"
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                        "tituloSerie" => "Lancet"
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                      "titulo" => "ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation"
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                          "colaboracion" => "Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology &#40;ESC&#41;"
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                          "autores" => array:3 [
                            0 => "P&#46;G&#46; Steg"
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                      "doi" => "10.1093/eurheartj/ehs215"
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                        "tituloSerie" => "Eur Heart J"
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Evidenced-Based Cardiology
Cochrane Corner: Intra-aortic balloon pump in patients with cardiogenic shock following myocardial infarction
Daniel Caldeiraa,b,c,
Corresponding author
dgcaldeira@hotmail.com

Corresponding author.
, Hélder Pereirac, João Costaa,b,d,e, António Vaz-Carneirod,e
a Laboratório de Farmacologia Clínica e Terapêutica, Faculdade Medicina, Universidade de Lisboa, Lisboa, Portugal
b Unidade de Farmacologia Clínica, Instituto de Medicina Molecular, Lisboa, Portugal
c Serviço de Cardiologia, Hospital Garcia de Orta, Almada, Portugal
d Centro de Estudos de Medicina Baseada na Evidência, Faculdade Medicina, Universidade de Lisboa, Lisboa, Portugal
e Centro Colaborador Português da Rede Cochrane Iberoamericana, Portugal
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">30-day mortality with IABP &#40;adapted from Unverzagt et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a>&#41;&#46; CI&#58; confidence interval&#59; HR&#58; hazard ratio&#59; IABP&#58; intra-aortic balloon pump counterpulsation&#59; RCTs&#58; randomized controlled trials&#59; VADs&#58; ventricular assist devices&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="tb0005"></elsevierMultimedia></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical question</span><p id="par0015" class="elsevierStylePara elsevierViewall">What is the impact of intra-aortic balloon pump counterpulsation &#40;IABP&#41; in patients with cardiogenic shock following acute myocardial infarction &#40;MI&#41;&#63;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Objectives</span><p id="par0020" class="elsevierStylePara elsevierViewall">To evaluate the efficacy and safety of IABP versus non-IABP treatment in patients with MI complicated by cardiogenic shock&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Description of review</span><p id="par0025" class="elsevierStylePara elsevierViewall">A systematic review was performed of all randomized controlled trials &#40;RCTs&#41; of patients with MI complicated by cardiogenic shock<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> that assessed the use of IABP compared to non-IABP treatment including other ventricular assist devices&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Searches of the Cochrane Central Register of Controlled Trials &#40;CENTRAL&#41;&#44; MEDLINE&#44; EMBASE&#44; LILACS&#44; IndMed&#44; KoreaMed&#44; and registers of ongoing trials were performed in October 2013&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Data were pooled in meta-analyses&#46; Hazard ratios &#40;HR&#41; with 95&#37; confidence intervals &#40;CI&#41; were used to express time-related variables such as time to event and dichotomous variables were expressed as odds ratios &#40;OR&#41; with 95&#37; CI&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">Seven trials were included&#44; with a total of 790 patients &#40;406 in the intervention groups and 384 in the control groups&#41;&#46; Four trials compared IABP to standard therapy and three to other left ventricular assist devices &#40;two with the TandemHeart<span class="elsevierStyleSup">&#174;</span> and one with the Impella<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">None of the trials were blinded to treatment allocation&#46; All patients were revascularized&#44; 95&#37; by primary angioplasty and 5&#37; by fibrinolysis&#46; Mean time of IABP support was 59 hours&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The proportion of fatal events at 30 days was around 40&#37;&#46; Aggregate analysis of the trials provided no evidence for a beneficial effect of IABP on mortality 30 days after the index event &#40;HR 0&#46;95&#59; 95&#37; CI 0&#46;76&#8211;1&#46;19&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; Six-month mortality was also similar to other treatment strategies &#40;OR 0&#46;96&#59; 95&#37; CI 0&#46;71&#8211;1&#46;30&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">During hospitalization&#44; 15 &#40;4&#46;12&#37;&#41; out of 364 patients from the intervention groups suffered severe adverse events &#40;reinfarction or stroke&#41;&#44; compared to five &#40;1&#46;38&#37;&#41; out of 363 from the control groups&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Available evidence&#44; based on RCTs&#44; does not support the systematic use of IABP in patients with cardiogenic shock secondary to MI to improve survival&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Comment</span><p id="par0065" class="elsevierStylePara elsevierViewall">Cardiogenic shock is a complication of MI in 5&#8211;7&#37; of cases and is associated with high mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> There is little evidence concerning treatment of this extremely serious condition&#59; only coronary revascularization has been shown to reduce mortality significantly at six months&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The physiological basis for inflation of an IABP in the thoracic aorta in diastole is that it will improve certain hemodynamic parameters that affect prognosis&#44; particularly by enhancing coronary flow&#44; reducing afterload and increasing the cardiac index&#46; As with any medical intervention&#44; its systematic use must be based on methodologically robust studies&#46; In this review&#44; IABP did not reduce mortality in either the short or long term in the pooled analysis of RCTs&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">1&#44;4</span></a> With regard to the adverse events most often associated with IABP &#40;stroke&#44; peripheral ischemic vascular complications&#44; bleeding and sepsis&#41;&#44; the most robust study &#40;IABP-SHOCK II&#41; showed no significant differences between IABP and medical therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">It should be borne in mind that the overall assessment of the impact of IABP in this systematic review is limited by certain factors&#44; including the lack of blinding to treatment allocation&#44; the inclusion of trials with small study populations and high crossover rates&#44; and the inclusion of patients with IABP at randomization&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Clinical implications</span><p id="par0080" class="elsevierStylePara elsevierViewall">The European Society of Cardiology guidelines for the management of MI with ST-segment elevation state that IABP may be considered &#40;class of recommendation IIb&#44; level of evidence B&#41; in patients with MI complicated by cardiogenic shock&#44; while other ventricular assist devices have the same class of recommendation &#40;IIb&#41; but a lower level of evidence &#40;C&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The American College of Cardiology Foundation&#47;American Heart Association guidelines for the management of heart failure give class of recommendation IIa&#44; level of evidence B&#44; for ventricular assist devices in patients with MI and cardiogenic shock refractory to medical therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">IABP thus has only a secondary role in the treatment of MI-related cardiogenic shock&#44; and its routine use is not recommended&#44; since the intervention does not lead to clear benefits&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ethical disclosures</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Protection of human and animal subjects</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Confidentiality of data</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Right to privacy and informed consent</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Improvement of hemodynamic parameters is the rationale for the use of intra-aortic balloon pump counterpulsation &#40;IABP&#41; in patients with cardiogenic shock following acute myocardial infarction &#40;MI&#41;&#46; This Cochrane systematic review evaluated the impact of this intervention in reducing mortality&#46; Seven randomized controlled trials with a total of 790 patients were included &#40;four using medical therapy as a comparator&#44; and three comparing IABP with other ventricular assist devices&#41;&#46; IABP did not reduce mortality in either the short or long term&#46; Therefore&#44; the systematic use of IABP in patients with cardiogenic shock following MI cannot be recommended&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A melhoria de par&#226;metros hemodin&#226;micos justifica o uso do bal&#227;o intra-a&#243;rtico &#40;BIA&#41; em doentes com enfarte agudo do mioc&#225;rdio &#40;EAM&#41; complicado por choque cardiog&#233;nico&#46; Esta revis&#227;o sistem&#225;tica da <span class="elsevierStyleItalic">Cochrane</span> avaliou o potencial impacto desta interven&#231;&#227;o na mortalidade&#46; Foram avaliados sete ensaios cl&#237;nicos aleatorizados e controlados com um total de 790 doentes &#40;quatro estudos utilizando a terap&#234;utica m&#233;dica como comparador e tr&#234;s estudos compararam o BIA com outros dispositivos de assist&#234;ncia ventricular&#41;&#46; O uso de BIA n&#227;o reduziu significativamente a mortalidade a curto ou a longo prazo nos doentes com EAM e choque cardiog&#233;nico&#46; N&#227;o existe evid&#234;ncia que suporte o seu uso sistem&#225;tico nestes doentes&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">30-day mortality with IABP &#40;adapted from Unverzagt et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a>&#41;&#46; CI&#58; confidence interval&#59; HR&#58; hazard ratio&#59; IABP&#58; intra-aortic balloon pump counterpulsation&#59; RCTs&#58; randomized controlled trials&#59; VADs&#58; ventricular assist devices&#46;</p>"
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                      "titulo" => "Intra-aortic balloon pump counterpulsation &#40;IABP&#41; for myocardial infarction complicated by cardiogenic shock"
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                          "etal" => true
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                        "paginaInicial" => "CD007398"
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            1 => array:3 [
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                    0 => array:2 [
                      "titulo" => "Thirty-year trends &#40;1975 to 2005&#41; in the magnitude of&#44; management of&#44; and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction&#58; a population-based perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;J&#46; Goldberg"
                            1 => "F&#46;A&#46; Spencer"
                            2 => "J&#46;M&#46; Gore"
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                        ]
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.108.814947"
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                        "tituloSerie" => "Circulation"
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              "referencia" => array:1 [
                0 => array:2 [
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                      "titulo" => "Early revascularization in acute myocardial infarction complicated by cardiogenic shock&#46; SHOCK Investigators&#46; Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock"
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                        0 => array:2 [
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                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Hochman"
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                            2 => "J&#46;G&#46; Webb"
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                    0 => array:2 [
                      "doi" => "10.1056/NEJM199908263410901"
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                      "titulo" => "Intraaortic balloon pump in cardiogenic shock II &#40;IABP-SHOCK II&#41; trial investigators&#46; Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock &#40;IABP-SHOCK II&#41;&#58; final 12 month results of a randomised&#44; open-label trial"
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                            2 => "F&#46;J&#46; Neumann"
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                      "doi" => "10.1016/S0140-6736(13)61783-3"
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                        "tituloSerie" => "Lancet"
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                      "titulo" => "ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation"
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                          "autores" => array:3 [
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Article information
ISSN: 21742049
Original language: English
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Idiomas
Revista Portuguesa de Cardiologia (English edition)
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