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Objective: Intra-aortic balloon pump (IABP), a mechanical hemodynamic support device, had widely been used to treat cardiogenic shock patients for several decades. However, the information about the predictive factors associated with mortality was scarce. This study aims to identify the predictive factors associated with in-hospital mortality in acute coronary syndrome (ACS) patients who performed IABP for their hemodynamic support during admission. Methods: We conduct a retrospective cohort study design. All admission records of ACS patients with IABP at Suratthani Hospital between October 2015 and September 2019 were retrieved. Results: Overall 75 ACS patients with IABP insertion were enrolled. Thirty-one patients died during admission, in-hospital mortality was 41.3%. From the multivariable analysis, we identified 3 predictors associated with inhospital mortality included cardiac arrest at presentation (adjusted OR [aOR]=11.18, 95%CI: 2.42-51.57, P=0.002), a higher number of inotropes or vasopressors (aOR 6.10, 95%CI 1.36-27.24, P=0.018) and Killip class IV (aOR 5.64, 95%CI 1.01-31.39, P=0.048). Conclusion: ACS patients who required IABP support had high mortality. Cardiac arrest, Killip class IV (cardiogenic shock) at presentation and requiring a higher number of inotropes or vasopressors were independent predictive factors of in-hospital mortality. [ABSTRACT FROM AUTHOR] more...