Clinical trial NCT06468982: Use of Intra-aortic Balloon Pump Before Surgery for Acute Myocardial Infarction
Official title: Evidence of the Advantages of Preoperative Intra-aortic Balloon Pump in Surgical Revascularization of Acute Myocardial Infarction
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Acute Myocardial Infarction
Coronary Artery Disease
Coronary Bypass Graft Stenosis of Autologous Vessel
Troponin
IABP - Disorder of Intra-Aortic Balloon Pump
Keywords: Acute myocardial infarction
coronary artery bypass surgery
intra-aortic balloon pump
high-sensitivity cardiac troponin I
Lead sponsor: Ataturk University
Sponsor class: OTHER
First posted: 2024-06-21
Enrollment: 156
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: two groups for patients with acute myocardial infarction scheduled for coronary artery bypass Grafting: Group A with IABP support, and Group B (the control group) without IABP
Primary purpose: TREATMENT

Brief summary: The optimal timing of surgery in patients with acute myocardial infarction (AMI) and the utilization of preoperative intra-aortic balloon pumps (IABP) in these patients are subjects of ongoing discussion and disagreement. This study aimed to investigate the effects of preoperative IABP on troponin levels, surgical timing, and intraoperative and postoperative outcomes for patients with AMI who undergo coronary artery bypass grafting (CABG).

Detailed description: Percutaneous coronary intervention (PCI) is the first treatment for myocardial ischemia; however, if left main coronary artery disease, multivessel disease, or complex architecture disable PCI, 10% of patients may need coronary artery bypass grafting (CABG). Abstinence from surgical reperfusion in patients with acute myocardial infarction (AMI) may be justified due to surgery's 50% mortality rate. An intra-aortic balloon pump (IABP) can help patients who have ongoing ischemia and high cardiac enzymes because it changes the way the heart uses oxygen by increasing coronary blood flow and lowering afterload. Some guidelines do not recommend the use of IABP in patients with AMI except for mechanical complications or shock. Nevertheless, it is commonly acknowledged that the specific criteria for employing IABP differ among clinics and are determined by clinical expertise. Patients with AMI who have impaired coronary perfusion and require surgical revascularization can benefit from preoperative intra-aortic balloon pump (IABP) support. This intervention leads to reorganization of coronary perfusion, resulting in a decrease in elevated troponin levels and quicker myocardial recovery.

Eligibility criteria: Inclusion Criteria:

* Patients who have had acute myocardial infarction and have been decided on coronary surgical revascularization

Exclusion Criteria:

* mechanical complications of Acute Myocardial Infarction (such as a ruptured chordal or ventricular septum)
* peripheral arterial disease
* renal failure
* history of cerebrovascular accident
* acute cardiogenic shock and cardiac arrest
* reoperation and combined operations

Primary outcomes:
measure: High-Sensitivity Cardiac Troponin Levels From Days 0-7
timeFrame: 0-7 days
Secondary outcomes:
measure: In-hospital Mortality
timeFrame: 0-30 days
Other outcomes:
Locations:
city: Yakutiye
country: Turkey
facility: Atatürk University
state: Erzurum
city: Erzurum
country: Turkey
facility: Atatürk University
Study officials:
affiliation: Ataturk University
name: Ümit Arslan, assoc prof
role: PRINCIPAL_INVESTIGATOR
References: