Background: Intra-aortic balloon pumping (IABP) provides potent supports on hemodynamic status of patients with cardiac shock through decreasing end-diastolic pressure and increasing cardiac output. We aimed to evaluate the impact of the timing of IABP induction on clinical prognosis in AHF patients at very high risk. Methods and Results: Of 404 AHF patients who were urgently admitted to the intensive care unit, 60 patients with both of left ventricular ejection fraction <35% and systolic blood pressure on admission <100 mmHg were ultimately enrolled in this study. The study population were divided into 3 groups depending on IABP use; the Early IABP group (induced at ≤3 days after admission, n = 18), Late IABP group (≥4 days, n = 16) and Non-IABP group (n = 26). Patient background on admission was not significantly different among 3 groups. However, in-hospital mortality in the Early IABP group was 6%, that was significantly lower than that in Late group (vs. 31%, P = .049) and in Non-IABP group (vs. 35%, P = .024). Additionally, hospital stay of patients who discharged alive in the Early IABP group was significantly shorter than other 2 groups (21 [12–49] vs. 68 [26–93] vs. 40 [24–64] days, P = .024). Conclusions: Early induction of IABP is one of the therapeutic options for improvement of in-hospital prognosis in AHF patients at very high risk.
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