{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:10:44Z","timestamp":1792782644068,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Freiburg","id":[{"id":"https:\/\/ror.org\/03vzbgh69","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal timing of intra-aortic balloon pump (IABP) initiation in cardiogenic shock (CS) complicating acute myocardial infarction (AMI) remains uncertain. Contemporary ESC guidance and the recent EACTS\/STS\/AATS MCS guideline highlight gaps regarding timing, patient selection, and ischemic burden. In this study, the association between IABP timing, myocardial area at risk (AAR), and survival in AMI-CS was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 399 AMI-CS patients treated with primary PCI at two tertiary centers. Patients were categorized as no IABP (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009124), non-rescue IABP (started during PCI;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009216), or rescue IABP (inserted after PCI;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959). Clinical and angiographic parameters, including AAR quantified by a coronary anatomy\u2013based algorithm, were assessed. Multivariable logistic regression identified predictors of in-hospital and 1-year mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Non-rescue IABP was independently associated with lower in-hospital mortality vs. no IABP (OR 0.29, 95% CI 0.16\u20130.52). Rescue IABP showed a weaker association with lower in-hospital mortality (OR 0.41, 95% CI 0.19\u20130.89). At 1\u00a0year, mortality was higher in both no IABP (OR 3.27, 95% CI 1.86\u20135.76) and rescue IABP groups (OR 2.04, 95% CI 1.04\u20133.98) compared with non-rescue IABP. An augmented inverse-probability weighted (AIPW) analysis confirmed these findings, demonstrating a significant reduction in 1-year mortality with early IABP use compared with no IABP (ATE\u2009\u2212\u20090.24, 95% CI\u2009\u2212\u20090.375 to\u2009\u2212\u20090.104), whereas no significant effect was observed for rescue IABP. A significant interaction between AAR and timing indicated that early IABP offered the greatest benefit in patients with moderate AAR (30\u201355%), whereas no benefit was observed with extensive AAR (&gt;\u200980%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In AMI-CS, early IABP initiation was associated with improved in-hospital and long-term survival, particularly in patients with a moderate AAR. These findings support the need for refining IABP use based on both ischemic burden and the timing of hemodynamic support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number and date of registration.<\/jats:title>\n                    <jats:p>DRKS00038637, 03.12.2025.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02951-1","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:15:15Z","timestamp":1780917315000},"page":"2005-2014","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Timing of IABP initiation and its impact on outcomes in acute myocardial infarction with cardiogenic shock: insights from a bi-center retrospective study"],"prefix":"10.1007","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1009-084X","authenticated-orcid":false,"given":"Istvan","family":"Bojti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarolta","family":"Bojtine Kovacs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kovacs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Ziegler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Maier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miroslaw","family":"Ferenc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila Csaba","family":"Nagy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalman","family":"Racz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Koszegi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor Tamas","family":"Szabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"2951_CR1","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","volume":"39","author":"B Ibanez","year":"2018","unstructured":"Ibanez B et al (2018) 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. 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