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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIntraaortic balloon pump counterpulsation prior to percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction does not reduce infarct size, as measured by magnetic resonance imaging, according to results from the ounterpulsation Reduces Infarct Size Acute Myocardial Infarction trial.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EMyocardial Infarction\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIntraaortic balloon pump counterpulsation (IABP) prior to percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) does not reduce infarct size, as measured by magnetic resonance imaging (MRI), according to results from the Counterpulsation Reduces Infarct Size Acute Myocardial Infarction trial. Manesh Patel, MD, Duke University, Durham, North Carolina, USA, reported outcomes from the study [Patel MR et al. \u003Cem\u003EJAMA.\u003C\/em\u003E 2011; CRISP AMI; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00833612\u0026amp;atom=%2Fspmdc%2F11%2F10%2F21.1.atom\u0022\u003ENCT00833612\u003C\/a\u003E].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ECRISP AMI was an open-label, multicenter, randomized, controlled trial that included 337 patients with STEMI that involved the anterior wall who presented within 6 hours of chest pain onset and without cardiogenic shock. Patients were randomly assigned to receive IABP, which was placed prior to PCI and continued for at least 12 hours, or primary PCI with IABP used as \u201cbailout,\u201d if necessary.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe objective of the study was to determine if routine IABP placement prior to reperfusion in patients with anterior STEMI without shock reduces myocardial infarct size. The primary outcome was infarct size, expressed as a percentage of left ventricular (LV) mass, as measured by cardiac MRI that was performed 3 to 5 days after PCI. Secondary endpoints included all-cause death at 6 months, rates of vascular complications, major bleeding, and transfusions at 30 days.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EA total of 337 patients were randomized to either IABP prior to PCI (n=161) or standard PCI with \u201cbailout\u201d IABP if necessary (n=176). PCI was successfully performed in 94% of patients, and the left anterior descending artery was the target vessel in 97.6%. The crossover rate (patients in the standard PCI group who required IABP due to hemodynamic instability) was 8.5% (n=9).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EMean infarct size was not statistically significantly different between the patients in the IABP plus PCI group and in the standard PCI group (42.1% [95% CI, 38.7% to 45.6%] vs 37.5% [95% CI, 34.3% to 40.8%], respectively; p=0.06). Results were similar in the subgroup of patients with proximal left anterior descending disease and TIMI flow scores of 0 or 1 (46.7% [95% CI, 42.8% to 50.6%] vs 42.3% [95% CI, 38.6% to 45.9%], respectively; p=0.11).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EAt 30 days, there were no significant differences between the treatment groups with respect to major vascular complications (4.3% [95% CI, 1.8% to 8.8%] vs 1.1% [95% CI, 0.1% to 4.0%]; p=0.09) and major bleeding or transfusions (3.1% [95% CI, 1.0% to 7.1%] vs 1.7% [95% CI, 0.4% to 4.9%]; p=0.49) for IABP plus PCI versus standard PCI. At 6 months, there was no significant difference in outcomes, including mortality (p=0.12) and the composite of death, MI, or congestive heart failure (p=0.15).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EOverall, this trial showed no benefit in terms of infarct size reduction in the use of routine IABP prior to PCI in patients with anterior STEMI. In addition, no significant differences between the IABC plus PCI group and the standard PCI group were observed in clinical endpoints. The authors concluded that the routine use of IABC in patients with anterior wall STEMI without cardiogenic shock does not lead to a reduction in infarct size at Days 3 to 5 or to an improvement in clinical outcomes at 6 months.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/10\/21.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmz01\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}