Intra-aortic balloon counterpulsation in US and non-US centres: Results of the benchmark® registry

Marc Cohen, Philip Urban, Jan T. Christenson, Debra L. Joseph, Robert J. Freedman, Michael F. Miller, E. Magnus Ohman, Ramachandra C. Reddy, Gregg W. Stone, James J. Ferguson

Research output: Contribution to journalArticlepeer-review

159 Scopus citations


Aims: To examine differences in patient characteristics and outcomes in 19 636 patients enrolled in the USA and 3027 patients enrolled in other countries undergoing intra-aortic balloon pump (IABP) counterpulsation. Methods and results: Indications for IABP use; a larger percentage of US patients were identified as 'early support and stabilization for angiography or angioplasty' (21.1% US vs 11.8% non-US), and 'pre-operative support for high-risk CABG' (15.9% vs 6.6%). A smaller percentage of US patients vs non-US patients were identified as 'weaning from cardiopulmonary bypass' (14.3% vs 28.2%), and 'refractory ventricular failure' (6.2% vs 9.8%). One out of five patients in both groups was listed as 'cardiogenic shock' (18.9% US vs 20.2% non-US). All cause, risk-adjusted, in-hospital mortality (20.1% vs 28.7%; P<0.001), and mortality with IABP in place (10.8% vs 18.0%; P<0.001) were lower at US vs non-US sites. In both US and non-US institutions, IABP associated complication rates, such as IABP-related mortality (0.05% vs 0.07%), major limb ischaemia (0.9% vs 0.8%), and severe bleeding (0.9% vs 0.8%), were low. Conclusions: IABP counterpulsation is deployed at an earlier clinical stage in US patients. Mortality rates are higher for non-US patients, particularly for patients with non-surgery cardiac interventions, even after adjusting for risk factors. Complication rates were low. Physicians should therefore not be reluctant to use IABP in high-risk patients undergoing cardiac procedures.

Original languageEnglish
Pages (from-to)1763-1770
Number of pages8
JournalEuropean Heart Journal
Issue number19
StatePublished - Oct 2003
Externally publishedYes


  • Balloon
  • Heart assist device
  • Peripheral vascular disease
  • Population


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