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September 9, 1974

External Counterpulsation: Management of Cardiogenic Shock After Myocardial Infarction

Author Affiliations

From the departments of surgery (Drs. Soroff and Cloutier and Mr. Birtwell) and medicine (Dr. Messer), Tufts University School of Medicine, and Tufts Surgical Service (Drs. Soroff and Cloutier and Ms. Begley), and the Tufts Medical Service (Dr. Messer), Boston City Hospital, Boston. Dr. Soroff and Mr. Birtwell are now at the School of Medicine, State University of New York and Stony Brook, and the Veterans Administration Hospital, Northport, NY. Dr. Cloutier is now at the US Naval Hospital, Philadelphia. Dr. Messer is now at Rush-Presbyterian-St. Luke's Hospital, Chicago.

JAMA. 1974;229(11):1441-1450. doi:10.1001/jama.1974.03230490029019

Twenty patients in cardiogenic shock following myocardial infarction were treated with external counterpulsation. Eleven patients died during or soon after treatment. One patient survived for three days and another for three weeks; both died in the hospital of complications apparently unrelated to counterpulsation. Seven patients were discharged from the hospital and remained well. The patients who responded to external counterpulsation did so within the first few hours. There seemed to be no benefit in applying counterpulsation for more than six hours. Sequential analysis of mortality statistics indicated that the 45% survival rate (which included the two short-term survivors) was a significant improvement (P<.01) over the usual 15% survival rate in cases of cardiogenic shock.

(JAMA 229:1441-1450, 1974)