Abstract:Objective To analyze the appropriate timing and patient selection for the use of intra-aortic balloon pump（IABP）in acute myocardial infarction（AMI）complicated with cardiogenic shock or acute heart failure （AHF）.Methods A retrospective analysis was conducted on the clinical data of patients who underwent coronary angiography（CAG）and percutaneous coronary intervention（PCI）at Nanjing Jiangbei Hospital from June 2016 to June 2024.Results A total of 256 patients underwent emergency PCI，among which 21 received IABP insertion. Of these 21 patients，7 died during hospitalization（death group），and 14 survived（survival group）. IABP was inserted in 13 patients due to cardiogenic shock（shock group）and in 8 patients due to AHF（AHF group）. All patients in the death group had extensive myocardial ischemia due to occlusion of the main artery，with IABP inserted before PCI in 6 cases（6/7）. There were statistically significant differences between the death group and survival group in terms of AMI complications（complicated by cardiogenic shock or AHF）and culprit lesion（P<0.05）. In the shock group，IABP was inserted in 11 patients（11/13）before PCI，while in the AHF group，6 patients（6/8）had IABP inserted before PCI.There were statistically significant differences between the shock and AHF groups in terms of infarct location，low-density lipoprotein cholesterol levels，proportion of right ventricular temporary pacing，and IABP use duration（P<0.05）. Conclusion In emergency PCI for AMI complicated with cardiogenic shock and AHF，IABP should be inserted before PCI when routine medication failed to maintain the hemodynamic stability，especially in cases with extensive myocardial ischemia due to occlusion of the main coronary artery.