Journal of cardiovascular pharmacology and therapeutics
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J. Cardiovasc. Pharmacol. Ther. · Mar 2012
Review Meta AnalysisCardiovascular outcomes using intra-aortic balloon pump in high-risk acute myocardial infarction with or without cardiogenic shock: a meta-analysis.
Intra-aortic balloon pump (IABP) has been widely used ever since it was first developed in 1962 and became part of clinical practice in 1968. It is used to treat patients with complications of acute myocardial infarction (AMI) such as cardiogenic shock, refractory left ventricular failure, and for high-risk patients undergoing angioplasty and coronary artery bypass grafting. However, current literature demonstrates a significant variance in terms of indications for using IABP and its outcomes. The aim of this study is to review the existing literature to analyze whether the use of IABP offers any cardiovascular benefit to the patients with AMI and the complications associated with the use of IABP. Material and ⋯ The present meta-analysis suggests that patients with high-risk AMI without cardiogenic shock do not seem to benefit from the use of IABP as measured by in-hospital mortality, rate of reinfarction, and recurrent angina. However, in patients with AMI with cardiogenic shock (systolic blood pressure [SBP] < 90), there was significant reduction in mortality using IABP. The use of IABP is associated with increase in the rate of both moderate and severe bleeding.
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J. Cardiovasc. Pharmacol. Ther. · Mar 2012
Comparative StudyComparative effects of nesiritide and nitroglycerin on renal function, and incidence of renal injury by traditional and RIFLE criteria in acute heart failure.
Acute renal insufficiency is associated with poorer outcomes in heart failure. Data regarding the renal effects of vasodilatory therapy in acute heart failure are inconclusive. ⋯ The incidence of renal injury was not different between nesiritide- and nitroglycerin-treated patients with acute heart failure; however, nitroglycerin was associated with a decline in glomerular filtration rate and increase in blood urea nitrogen despite higher baseline and on treatment blood pressures.