Intraaortic Balloon Support for Cardiogenic Shock

To the Editor: In the study by Thiele et al. (Oct. 4 issue) 1 on the use of intraaortic balloon counterpulsation (IABP) in patients with cardiogenic shock caused by acute myocardial infarction, the authors' conclusion that IABP did not significantly reduce 30-day mortality has to be taken with caution. In one fourth of the patients in the study, the right coronary artery was the infarct-related vessel and right ventricular infarction might have contributed to the hemodynamics. Furthermore, the average systolic blood pressure was 89 mm Hg, and the mean heart rate was 92 beats per minute. In many patients, the inclusion . . .