Th an ACS was 15.four . This group was characterised by the following: woman (P < 0.0001), higher age (P = 0.0001), less weight (P = 0.01), higher frequency of high blood pressure (P = 0.0001), diabetes mellitus (P = 0.0001), history of ischaemic heart disease (P = 0.002) and peripheral artery disease (P = 0.0001). This group presented a major proportion of the NSTEMI (P = 0.015), higher level of renal dysfunction (77 to 32 , P = 0.0001), and microalbuminuria (61 to 32 , P = 0.0001). Patients with anaemia presented aSAvailable online http://ccforum.com/supplements/11/SConclusion Our data demonstrate that baseline anemia is a strong and independent predictor of future adverse events at 2 years in patients with STEMI treated with PCA.P238 Intra-aortic balloon counterpulsation: impact on patient hemodynamics in acute myocardial infarction complicated by cardiogenic shockJ Brazdzionyte, A Macas, A Mickeviciene, G Baksyte Kaunas University of Medicine, Kaunas, Lithuania Critical Care 2007, 11(Suppl 2):P238 (doi: 10.1186/cc5398) Introduction Evaluation of hemodynamics in patients with acute myocardial infarction (AMI) is crucial. Hemodynamic changes Combretastatin A4 chemical information during intra-aortic balloon counterpulsation (IABC) are monitored using invasive methods for assessment of hemodynamics in patients with cardiogenic shock (CS). Objective To evaluate hemodynamic indices in patients with AMI, complicated by CS and managed with IABC during initial days of treatment. Methods Hemodynamic indices including cardiac output (CO), cardiac index (CI), mean pulmonary artery pressure (MPAP) and pulmonary capillary wedge pressure (PCWP) were measured by pulmonary artery catheterization using an intermittent thermodilution technique for patients with AMI complicated by CS, admitted within 12 hours from the onset of pain and managed by IABC. All measurements were performed within 48 hours after initiation of IABC. Results Twenty-nine patients were investigated according to the study protocol: 15 (51.7 ) men and 14 (48.3 ) women. Average age was 71.4 ?6.9 years. Anterior AMI was diagnosed for 19 (65.5 ) patients, and inferior in 10 (34.5 ) patients. Primary percutaneous transluminal coronary angioplasty (PTCA) was successfully performed for 22 (75.9 ) patients, primary PTCA was unsuccessful for four (13.8 ) patients, and seven (24.1 ) patients underwent scheduled cardiac surgery within the first 2 weeks. The inhospital mortality rate was 41.4 (12 patients). The initial (after initiation of IABC) CO was 3.7 ?1.2 l/min, CI was 1.9 ?0.7 l/min/m2, MPAP was 30 ?7.1 mmHg (maximum 43 PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/2073976 mmHg), PCWP was 19.1 ?five.1 mmHg (maximum 26 mmHg). Right after the very first 24 hours of IABC, the CO was three.eight ?1.6 l/min, CI was two ?0.9 l/min/m2, MPAP was 23.7 ?7.1 mmHg (maximum 36 mmHg), PCWP was 16.8 ?four mmHg (maximum 24 mmHg). After 48 hours of IABC, CO was four.1 ?1.7 l/min, CI was two.1 ?0.eight l/min/m2, MPAP was 23.8 ?six.five mmHg (maximum 44 mmHg), PCWP was 16.eight ?four.6 mmHg (maximum 24 mmHg). Conclusion Intra-aortic balloon counterpulsation features a good influence on hemodynamic modifications of sufferers with acute myocardial infarction complicated by cardiogenic shock during the initial days of remedy.P237 Cardiogenic shock in the Aachen Digital Myocardial Infarction RegistryA Kersten, M Merx, H D kers, M Kelm, W Lepper UK Aachen, Germany Critical Care 2007, 11(Suppl 2):P237 (doi: 10.1186/cc5397) Introduction Guideline-oriented therapy of acute coronary syndrome (ACS) with ST-elevation myocardial infarction (STEMI) calls for qui.