Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Device therapy

Where next in cardiogenic shock owing to myocardial infarction?

Intra-aortic balloon pumping has recently been shown to be ineffective in treating cardiogenic shock due to myocardial infarction. Other, more potent percutaneous pumps have been developed, and their use is growing substantially, but they have not been studied in randomized trials. Two new reports provide provocative information about these devices.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Haemodynamic effects and ventricular unloading with pVADs.

References

  1. Burkhoff, D. & Naidu, S. S. The science behind percutaneous hemodynamic support: a review and comparison of support strategies. Catheter. Cardiovasc. Interv. 80, 816–829 (2012).

    Article  Google Scholar 

  2. Thiele, H. et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N. Engl. J Med. 367, 1287–1296 (2012).

    Article  CAS  Google Scholar 

  3. Windecker, S. et al. 2014 ESC/EACTS guidelines on myocardial revascularization. Eur. Heart J. 35, 2541–2619 (2014).

    Article  Google Scholar 

  4. O'Gara, P. T. et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. Circulation 127, e362–e425 (2013).

    PubMed  Google Scholar 

  5. Ahmad, Y. et al. Intra-aortic balloon pump therapy for acute myocardial infarction: a meta-analysis. JAMA Intern. Med. http://dx.doi.org/10.1001/jamainternmed.2015.0569.

  6. Khera, R. et al. Trends in the use of percutaneous ventricular assist devices: analysis of National Inpatient Sample data, 2007 through 2012. JAMA Intern. Med. http://dx.doi.org/10.1001/jamainternmed.2014.7856.

  7. Seyfarth, M. et al. A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction. J. Am. Coll. Cardiol. 52, 1584–1588 (2008).

    Article  Google Scholar 

  8. Alexander, J. H. et al. Effect of tilarginine acetate in patients with acute myocardial infarction and cardiogenic shock: the TRIUMPH randomized controlled trial. JAMA 297, 1657–1666 (2007).

    Article  CAS  Google Scholar 

  9. Thiele, H., Ohman, E. M., Desch, S., Eitel, I. & de Waha, S. Management of cardiogenic shock. Eur. Heart J. 36, 1223–1230 (2015).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel Burkhoff.

Ethics declarations

Competing interests

D.B. declares that he is an employee of HeartWare International, and a consultant to BackBeat Medical, CardiacImplants, DC Devices Inc., and Sensible Medical. He has received grant support from Abiomed, is on the Heart Failure Advisory Board of the Sorin Group, and is the founder of PVLoops LLC.

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Burkhoff, D. Where next in cardiogenic shock owing to myocardial infarction?. Nat Rev Cardiol 12, 383–385 (2015). https://doi.org/10.1038/nrcardio.2015.81

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2015.81

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing