Concurrent implantation of intra-aortic balloon pumping with extracorporeal membrane oxygenation improved survival of patients with postcardiotomy cardiogenic shock

Background Extra-corporeal membranous oxygenation (ECMO)and intra-aortic balloon pumping (IABP) are widely used in patients with severe circulatory failure. The decision to initiate ECMO and IABP on optimal occasion in postcardiotomy cardiogenic shock (PCS) remains controversial in the absence of guidelines.

Effects on the renal artery blood flow during the intra-aortic balloonpumping was used

The effects of intra-aortic balloon pumping(IABP) on hemodynamic parameters inthe kidney were studied. The pulse produced by pumping activated the renal nervoussystem and reduced the renal vascular resistance. Therefore, the reduction of the renalvascular resistance is an important reason for the increase the renal blood flow duringintra-aortic balloon pumping.

Role of Intra-Aortic Balloon Pump in Off-Pump Coronary Artery Bypass —A Vettath Modification

Objective: Hemodynamic deterioration during positioning of the heart has been the most critical complication of off-pump coronary artery bypass surgery. Pre-operative use of intra-aortic balloon pump has been shown to prevent this complication in high risk patients. The role of balloon pump in high risk patients has been questioned by our group. We modified the role of balloon pump in our patients, thus avoiding the conversion to cardiopulmonary bypass. Methods: 4063 off-pump coronary bypass surgeries were performed by a single surgeon in our center, over thirteen years. 130 intra-aortic balloons used between July 2002 and December 2015 were removed from the the-ater, once the distal anastomosis was performed. We studied this group of patients for—time and need for insertion, duration of balloon used, local insertion problems and survival. Results: Initially, we inserted intra-aortic balloons in high risk patients. We observed that, patients with low ejection fraction and patients with critical left main coronary artery disease were not the ones who actually needed balloon pump support. It was the patients who had ongoing ischemia, with preserved left ventricular function, and ST depression intra-operatively, who needed balloon pump support to perform complete anatomical revascularization. Conclusions: Intra-aortic balloon pump has helped us to position the heart without hemodynamic instability, thereby avoiding conversion to cardio-pulmonary bypass. This enabled us to perform off-pump surgery in virtually all areas of the heart, thus maintaining perfect hemodynamics.

Anticoagulation therapy in intra-aortic balloon counterpulsation： Does IABP really need anti-coagulation ？

Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoag-ulation therapy. Methods: Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were random-ly assigned into two groups. Anticoagulation group( Group A) consisted of 71 patients who were given heparin intravenously with target aPTT 50 - 70 seconds. Non-anticoagulation group( Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products(FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded.Results: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups ( P < 0.05) . D-dimer and FDP level increased at 24 hours and 48 hours in both groups( P < 0.05), but returned to the baseline level 24 hours post IABP removal( P > 0.05) . Three patients in Group A and 2 patients in Group B developed minor limb ischemia( P > 0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B ( P <0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.

Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

Background: The intra-aortic balloon pumping (IABP) is the most used ventricular mechanical assist device. In recent years, the preoperative use in patients with severe ventricular dysfunction presents itself as a great benefic strategy to the postoperative recovery. This paper aim is to evaluate the IABP post-operative benefit in patients with severe ventricular dysfunction. Methods: From January 2011 to March 2016, 125 patients underwent a coronary artery bypass graft (CABG) with cardiopulmonary bypass and preoperative IABP in Teaching Hospital of the ABC Medical School and Hospital Estadual Mario Covas. The inclusion criteria were the presence of severe ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) less than or equal to 40%, estimated by Doppler echocardiography using the Simpson method. The preoperative LVEF was 30.25% ± 8.53% and the diastolic diameter of the left ventricle (LVDD) 67.75 ± 16.37 mm. IABP was installed approximately 15 hours before the surgery. Results: The patients required the IABP for 2.4 ± 1.58 days, and vasoactive drugs, 4.8 ± 2.12 days. We performed 3.2 ± 1.9 grafts per patient and the total length of stay was 07 ± 5.52 days. Cardiopulmonary bypass time was 67 ± 10.95 minutes and anoxia time, 46.4 ± 10.06 minutes. Twelve patients (9.6%) had pneumonia and four (3.2%), atrial fibrillation. We observed a LVDD reduction to 63 ± 16.26 (p = 0.068) and LVEF enhancement to 36.50 ± 16.86 (p = 0.144). The data were analyzed statistically according to the Wilcoxon test. There were no deaths. Conclusion: The initial experience of the authors with the preoperative IABP in patients with severe left ventricular dysfunction suggests great benefit in post-operative recovery with im-provement of LVEF and reduction of LVDD.

Peri-operative application of intra-aortic balloon pumping reduced in-hospital mortality of patients with coronary artery disease and left ventricular dysfunction

Background:There are few reports of peri-operative application of intra-aortic balloon pumping(IABP)in patients with coronary artery disease(CAD)and different grades of left ventricular dysfunction.This study aimed to analyze the early outcomes of perioperative application of IABP in coronary artery bypass grafting(CABG)among patients with CAD and left ventricular dysfunction,and to provide a clinical basis for the peri-operative use of IABP.Methods:A retrospective analysis of 612 patients who received CABG in the General Hospital of People's Liberation Army between May 1995 and June 2014.Patients were assigned to an IABP or non-IABP group according to their treatments.Logistic regression analysis was performed to investigate the influence of peri-operative IABP implantation on in-hospital mortality.Further subgroup analysis was performed on patients with severe(ejection fraction[EF]≤35%)and mild(EF=36%-50%)left ventricular dysfunction.Results:Out of 612 included subjects,78 belonged to the IABP group(12.7%)and 534 to the non-IABP group.Pre-operative left ventricular EF(LVEF)and EuroSCOREII·predicted mortality was higher in the IABP group compared with the non-IABP group(P<0.001 in both cases),yet the two did not differ significantly in terms of post-operative in-hospital mortality(P=0.833).Regression analysis showed that IABP implantation,recent myocardial infarction,critical status,non-elective operation,and postoperative ventricular fibrillation were risk factors affecting in-hospital mortality(P<0.01 in all cases).Peri-operative IABP implantation was a protective factor against in-hospital mortality(P=0.0010).In both the severe and mild left ventricular dysfunction subgroups,peri-operative IABP implantation also exerted a protective role against mortality(P=0.0303 and P=0.0101,respectively).Conclusions:Peri-operative IABP implantation could reduce the in-hospital mortality and improve the surgical outcomes of patients with CAD with both severe and mild left ventricular dysfunction.

Thrombocytopenia in patients of acute coronary syndrome with intra-aortic balloon pumping placement

Background Thrombocytopenia is a common complication of IABP. Until now,there is no unified conclusions about the incidence,characteristics,risk factors and the prognosis of IABP related thrombocytopenia.Methods In this study,the data of patients with ACS undergoing PCI and IABP were retrospectively analyzed.All enrolled patients were divided into thrombocytopenia group and non-thrombocytopenia group according to the occurrence of thrombocytopenia after insertion of IABP. The baseline data of the two groups were compared,and the possible risk factors of thrombocytopenia and their impact on prognosis were analyzed by chi-square test and logistic regression analysis. Results Sixty-two patients were enrolled in this study. The rate ofIABP associated thrombocytopenia was 25.8%(16/62)of all patients. Older agewas an independent risk factor of IABP associated thrombocytopenia(OR:3.625;95% confidence interval:1.016-12.935;P=0.047). The incidence of TIMI bleeding events was higher in thrombocytopenia group[75.0%(12/16)vs. 43.5%(20/46),P=0.042]. The rate of in-hospital death was similar between the two groups[18.8%(3/16)vs. 17.4%(8/46),P=1.0]. Conclusion IABP associated thrombocytopenia occurs in 25.8% of patients with ACS undergoing PCI and correlates with increased TIMI bleeding events. Older age may predict IABP associated thrombocytopenia.

Clinical significance of intra-aortic balloon pumping on no-reflow phenomenon of primary percutaneous coronary intervention for acute myocardial infarction

Background Percutaneous coronary intervention （PCI） is used as a treatment for acute myocardial infarction （AMI）, and one of its major complications is the angiographic no-reflow phenomenon （NR）. Although intra-aortic balloon pumping （IABP） is sometimes used in such patients to increase the diastolic coronary blood flow, there is little available information regarding the effects of IABP on the angiographic no-reflow phenomenon. Method Twenty-two AMI patient with NR were performed primary PCI between January 2006 and December 2009, of which 12 patients were selected for IABP therapy and the left 10 were selected as the control group by group procedure of odd and even days; We observed the vasoactive substance in both groups on the days of 1, 2, 3, 5, 7, 10 after the different interventions, which include plasma renin activity （PRA）, angiotensin Ⅱ （ANG Ⅱ）, aldosterone （ALD）, adrenaline （E）, and noradrenalin （NE）; In addition, cardiac structure and cardiac ventricle systolic function including left atrium medial diameter （LAMD）, left ventricular medial diameter （LVMD） Finally, left ventricular ejection fraction （LVEF） were evaluated after 10 days, 3 months and 6 months; statistics was taken to analysis. Results According to the time concentration curve, vasoactive substance of the IABP group decreased faster than that of the control group, and this difference had statistical significance （P 〈 0.01 ） ; In terms of LAMD, LVMD, and LVEF, echocardiography difference of the IABP and the control group in 10 days, 3 months, and 6 months also showed statistical significance （P 〈 0.05）. Conclusions IABP can significantly reduce the release of vasoactive substances of NR in patients of primary PCI for AMI; LAMD, LVMD and LVEF in 10 days, 3 months, and 6 months can be improved using this method, which is conducive to recovery of heart function.

Application of intra-aortic balloon pumping on no-reflow phenomenon in primary PCI for STEMI

Background To investigate the effect of intra-aortic balloon pumping （IABP） on no-reflow phenomenon primary percutaneous coronary intervention （PCI） for ST-Elevation Myocardial Infarction （STEMI）. Methods Clinical data of 22 acute myocardial infarction patients after PCI with angiographic no-reflow phenomenon were retrospectively analyzed between January 2006 and December 2009.12 patients underwent IABP, other 10 patients as control group. We observed difference of cardiac structure, brain natriuretic peptide （BNP） and ventricular systolic function between two group, as well as cardiac injury markers （MYO,CK-MB, cTnI） in both groups on the days of 1, 2, 3, 5, 7, 10 after the different interventions. In addition, cardiac structure and ventricular systolic function including left atrium medial diameter （LAMD）, left ventricular medial diameter （LVMD）, left ventricular ejection fraction （LVEF） was evaluated after 10 days, 3 months,6 months Finally, statistics was used to analysis the data. Results The several vasoactive substances as well as cardiac injury markers and LAMD, LVMD, LVEF of 10 days, 3 months, 6 months of IABP group were significant difference with control group significant difference （P 〉 0.0 PCI with angiographic no-reflo （P 〈 0.05）. 5）. Conclusions w phenomenon, BNP targets of IABP group compared with the control group no IABP has effects on prognosis in STEMI patients who performed which is conducive to recovery of heart function.

Influence of preoperative coronary collateral circulation on in-hospital mortality in patients undergoing coronary artery bypass graft surgery with intra-aortic balloon pump support

Background Outcomes in patients requiring coronary artery bypass graft （CABG） surgery have been improved with devices such as the intra-aortic balloon pump （IABP）.Good coronary collateral circulation （CCC） has been shown to reduce mortality in patients with coronary artery disease （CAD）.We aimed to investigate whether poor preoperative CCC grade is a predictor of in-hospital mortality in CABG surgery requiring IABP support.Methods Fifty-five consecutive patients who were undergoing isolated first time on-pump CABG surgery with IABP support were enrolled into this study and CCC of those patients was evaluated.Results Twenty-seven patients had poor CCC and 28 patients had good CCC.In-hospital mortality rate in poor CCC group was significantly higher than good CCC group （14 （50％） vs.4 （13％）,P=0.013）.Preoperative hemoglobin level （OR：0.752; 95％ CI,0.571-0.991,P=0.043）,chronic obstructive pulmonary disease （OR：6.731; 95％ CI,1.159-39.085,P=0.034） and poor CCC grade （OR：5.750; 95％ CI,1.575-20.986,P=0.008） were associated with post-CABG in-hospital mortality.Poor CCC grade （OR：4.853; 95％ CI,1.124-20.952,P=0.034） and preoperative hemoglobin level （OR：0.624; 95％ CI,0.476-0.954,P=0.026） were independent predictors of in-hospital mortality after CABG.Conclusion Preoperative poor CCC and hemoglobin are predictors of in-hospital mortality after CABG with IABP support.

Efficacy and safety of intra-aortic balloon pump-assisted interventional therapy in different age groups of patients with acute coronary syndrome

Background Currently intra-aortic balloon pump （IABP） has been widely used in patients with acute coronary syndrome （ACS） who undergo percutaneous coronary intervention （PCI）. However, few studies have been done with regard to the clinical outcome and safety of IABP in assisting PCI in aged patients with ACS. The purpose of the present study was to evaluate the safety of tABP in different age groups of patients with ACS.Methods Data on 292 ACS patients who received IABP-assisted PCI in Shenyang General Hospital of People＇s Liberation Army were retrospectively analyzed. More specifically, the successful rate, mortality and complications associated with the treatment were compared between the senior （〉60 years old） and the non-senior （〈60 years old） groups of patients. Results The attack rate of non-ST segment elevation ACS was significantly higher in the senior group than in the non-senior group （38.8% vs 21.1%, P 〈0.01）. The incidence of the IABP-associated complications was not significantly different between both groups （P 〉0.05）.Conclusion The clinical outcome and safety of IABP-assisted PCI in the elderly patients were comparable to that for the non-elderly patients.

Superior mesenteric artery embolism as a fatal complication of intra-aortic balloon pump: A case report and literature review

INTRODUCTION The intra-aortic balloon pump(IABP)is commonly used as a cardiac assist device in various clinical situations,including cardiogenic shock,mechanical complications of acute myocardial infarction,high risk percutaneous coronary interventions(PCI),coronary artery bypass graft surgery and refractory unstable angina,etc.However,like other invasive devices,the use of IABP has been associated with some complications.The most frequently reported complications are hemorrhage and limb ischemia.Rare complications include infection,arterial perforation,aortic dissection and thrombocytopenia and bowel infarction.Arterial embolism of internal organs is a rare but fatal complication of IABP therapy.Sirbu et al.reported that 59%of patients who developed ischemic vascular complications due to IABP died1.

A comparative analysis of intra-aortic balloon pump in off-pump patients undergoing coronary artery bypass grafting at different perioperative stages

Background Intra-aortic balloon pump （IABP） has been widely used at present. We can use it at different stages of perioperative period in off-pump coronary artery bypass grafting （CABG）. However, when to used it was seldom confirmed. Methods From January 2008 to June 2012, the 89 coronary heart disease （CHD） patients accepted implantation of IABP at different stages of off-pump CABG, preoperative and postoperative ventricular systolic function, left ventricular remodeling situation and the changes of myocardial enzymes were evaluated. Results All the patients had left heart insufficiency and muhivessel disease. Their postoperative left ventricular systolic function and ventricular remodeling were significantly improved while myocardial enzymes decreased with preoperative interventional implantation of IABP. The perioperative mortality was 7.86% （7/89）. No patients had complication of IABP. Conclusion Earlier IABP implantation at preoperation is useful to improve heart function, improve the tolerability of surgery, reduce the incidence of postoperative low cardiac output syndrome （LCOS） and decrease the mortality.

延长主动脉内气囊反博术在急性心肌梗死合并泵衰竭中的研究

目的评价急诊主动脉内气囊反博术(Intra-aortic balloon pumping,IABP)对急性心肌梗死合并泵衰竭患者循环支持治疗的疗效及延长IABP循环支持治疗的安全性和有效性。方法临床确诊为急性心肌梗死合并泵衰竭患者共39例,均给予急诊IABP循环支持治疗,同时行经皮冠状动脉介入治疗(PCI)。72小时后将符合IABP脱机标准患者随机分为两组,A组停用IABP循环支持;B组继续维持IABP循环支持7天。观察患者IABP治疗前后左室功能恢复状况及两组安全性和有效性的差别。结果①IABP循环支持治疗后较治疗前患者平均动脉压(MAP)、心脏指数(CI)、左室射血分数(LVEF)、血氧饱和度(SaO2)明显提高,肺毛细血管楔压(PCWP)、心率(HR)明显下降。②住院期间延长IABP治疗组(B组)CI、LVEF增加,PAWP降低,与对照组(A组)比较两组间差异有统计学意义(P<0.05)。③随访1年,B组患者6分钟步行试验、LVEF值优于A组患者,两组间差异有统计学意义(P<0.05)。室壁瘤发生率和总死亡率无差别。结论①IABP对急性心肌梗死并发泵衰竭在急性期有明显的循环支持治疗效果。②延长IABP循环支持时间对急性心肌梗死并发泵衰竭患者左心功能的改善有益。

Percutaneous assist devices in acute myocardial infarction with cardiogenic shock: Review, meta-analysis

AIM: To assess the impact of percutaneous cardiac support in cardiogenic shock(CS) complicating acute myocardial infarction(AMI), treated with percutaneous coronary intervention. METHODS: We selected all of the studies published from January 1st, 1997 to May 15 st, 2015 that compared the following percutaneous mechanical support in patients with CS due to AMI undergoing myocardial revascularization:(1) intra-aortic balloon pump(IABP) vs Medical therapy;(2) percutaneous left ventricular assist devices(PLVADs) vs IABP;(3) complete extracorporeal life support with extracorporeal membrane oxygenation(ECMO) plus IABP vs IABP alone; and(4) ECMO plus IABP vs ECMO alone, in patients with AMI and CS undergoing myocardial revascularization. We evaluated the impact of the support devices on primary and secondary endpoints. Primary endpoint was the inhospital mortality due to any cause during the same hospital stay and secondary endpoint late mortality at 6-12 moof follow-up. RESULTS: One thousand two hundred and seventytwo studies met the initial screening criteria. After detailed review, only 30 were selected. There were 6 eligible randomized controlled trials and 24 eligible observational studies totaling 15799 patients. We found that the inhospital mortality was:(1) significantly higher with IABP support vs medical therapy(RR = +15%, P = 0.0002);(2) was higher, although not significantly, with PLVADs compared to IABP(RR = +14%, P = 0.21); and(3) significantly lower in patients treated with ECMO plus IABP vs IABP(RR =-44%, P = 0.0008) or ECMO(RR =-20%, P = 0.006) alone. In addition, Trial Sequential Analysis showed that in the comparison of IABP vs medical therapy, the sample size was adequate to demonstrate a significant increase in risk due to IABP. CONCLUSION: Inhospital mortality was significantly higher with IABP vs medical therapy. PLVADs did not reduce early mortality. ECMO plus IABP significantly reduced inhospital mortality compared to IABP.

Continuous internal counterpulsation as a bridge to recovery in acute and chronic heart failure

Cardiac recovery from cardiogenic shock(CS) and end-stage chronic heart failure(HF) remains anoften insurmountable therapeutic challenge. The counterpulsation technique exerts numerous beneficial effects on systemic hemodynamics and left ventricular mechanoenergetics, rendering it attractive for promoting myocardial recovery in both acute and chronic HF. Although a recent clinical trial has questioned the clinical effectiveness of short-term hemodynamic support with intra-aortic balloon pump(IABP, the main representative of the counterpulsation technique) in CS complicating myocardial infarction, the issue remains open to further investigation. Moreover, preliminary data suggest that long-term IABP support in patients with end-stage HF is safe and may mediate recovery of left- or/and right-sided cardiac function, facilitating long-term weaning from mechanical support or enabling the application of other permanent, life-saving solutions. The potential of long-term counterpulsation could possibly be enhanced by implementation of novel, fully implantable counterpulsation devices.

Efficacy of IABP in patients awaiting cardiac transplantation

Intra-aortic balloon pump (IABP)support is used in severalclinical situations.To determine its efficacy in patients with severe heartfailure awaiting cardiac transplantation,the experience at the Universityof Pittsburgh from May 1986 to October 1989 was reviewed.Of 392 patientson the waiting list,(16.3%) required IABP.All had previously been oninotropic support for varying periods of time.The ability to stabilize andto sustain the patient to cardiac transplantation was 75%.Twenty patients(31.3% of group) required and were provided more extensive mechanicalzsupport with either total artificial heart (n=ll) or left ventrieular assistdevice (n =9).Twenty-nine patients (45% of entire gronp) were able tohave the IABP removed prior to transplantation.Seventeen patients(26.6%)parameters demonstrated improvement with IABP.These data support IABPas a bridge to transplantation in patients with severe heart failure who havenot been stabilized on inotropie agents alone.These data also demonstratethat IABP support may only be required temporarily in a subgroup of pa-tients awaiting cardiac transplantation.

Re-engineering in OPCAB—A Vettath’s perspective

OPCAB (off pump coronary artery bypass) has become a preferred technique of coronary revascularization in India, and more so in the East. This technique was restarted by Buffalo and Bennetti who had published their results in 1985. Since then, there has been a great enthusiasm among coronary surgeons to develop and standardize this technique of CABG (coronary artery bypass grafting). In the late nineties, nearly all the coronary centers in India started performing this technique. But, by the early 2000, only a few surgeons continued this practice. Only those who could perform this OPCAB technique in nearly 100% of their patients continued this and the rest of them returned back to the conventional on pump CABG. To attain this result, we had to re-engineer our technique of anesthesia, surgical technique, stabilization, and positioning of the heart to enable us to perform OPCAB in all patients who needed CABG. We have analyzed our last 3000 patients operated by the same surgeon (Dr MPV), in the same center with the same team. As OPCAB was the only procedure performed for coronary revascularization, we have compared our first 1000 patients, with the second 2000 patients that underwent the procedure. Our technique and our results are presented.

Combined Application of Circulatory Assist Devices Following Cardiac Arrest in Patients after Cardiac Surgery

Objectives To evaluate retrospectively the potential benefits of combined utilization of various assisted circulation devices in cardiac arrest patients who did not respond to conventional cardiopulmonary cerebral resuscitation （CPCR）. Methods Assisted circulation devices, including emergency cardiopulmonary bypass （ECPB）, intra-aortic balloon pump （IABP）, and left ventricular assist device （LVAD）, were applied to 16 adult patients who had cardiac arrest 82 rain-56 h after open heart surgery and did not respond to 20 rain or longer conventional CPCR. ECPB was applied to 2 patients, ECPB plus IABP to 8 patients, ECPB plus IABP and LVAD to 6 patients. Results One patient recovered fully and one patient died. Of the other 14 patients, 13 resumed spontaneous cardiac rhythm and one did not; none of them could be weaned from ECPB. Further treatment of the 14 patients with combinations of assisted circulation devices enabled 6 patients to recover. One of the 7 recovered patients died of reoccurring cardiac arrest after 11 days; the other 6 were discharged in good condition and were followed up for 3-49 months （mean =22 months）. Of the 6 discharged patients one suffered cerebral embolism during LVAD treatment, resulting in mild limitation of mobility of the right limbs ; the other 5 never manifested any central nervous system complications. There was no late deaths giving a 37.5% （6/16） long-term survival rate. Conclusions ECPB could effectively reestablish blood circulation and oxygen supply, rectify acidosis, and improve internal milieu. The combined utilization of ECPB, IABP, and LVAD reduces the duration of ECPB, improves the incidence of recovery, and offers beneficial alternatives to refractory cardiac arrest patients.

Shenfu Injection(参附注射液) Inhibits Inflammation in Patients with Acute Myocardial Infarction Complicated by Cardiac Shock

Objectives： To investigate the effect of Shenfu Injection（参附注射液, SFI） on inflammatory factors in patients with acute myocardial infarction complicated by cardiogenic shock（CS） treated with and intra-aortic balloon pump（IABP）. Methods： This study enrolled 60 patients with ST-segment elevation myocardial infarction（STEMI） complicated by CS. Patients underwent IABP and emergency percutaneous coronary intervention（PCI） were randomly divided into two groups by random number table with 30 cases in each group, one given SFI treatment（100 m L/24 h）, one not. The two groups were then compared in a clinical setting for left ventricular function, biochemical indicators and Inflammatory factors, including C-reactive proteins（CRP）, interleukin-1（IL-1） and tumor necrosis factor alpha（TNF-α）. Major adverse cardiac and cerebrovascular events（MACCE） events were compared between patients of the two groups both in-hospital and in follow-ups. Results： The IABP support treatment times of patients in the IABP＋SFI group were significantly shorter than the IABP group（52.87±28.84 vs. 87.45±87.31, P=0.047）. In the patients of the IABP＋SFI group, the CRP peak appeared in 24 h after PCI operation. The CRP peak in the patients of the IABP＋SFI group was significantly lower than that in the IABP group（31.27±3.93 vs. 34.62±3.47, P=0.001）. The increases in range of TNF-α in the patients of the IABP＋SFI group were significantly lower than those of the IABP group（182.29±22.79 vs. 195.54±12.02, P=0.007）. The increases in range of IL-1 in the patients of the IABP＋SFI group were significantly lower than those of the IABP group（214.98±29.22 vs. 228.60±7.03, P=0.019）. The amplitude elevated TNF-α 72 h after admission was an independent risk factor of in-hospital MACCE events（OR 0.973, 95% CI 0.890–0.987, P=0.014） in patients with STEMI and CS. Conclusion： Patients with STEMI complicated by CS treated by IABP and SFI had a reduced inflammatory reaction, a reduced dependence of CS on IABP and shortened the course of disease.