Objective: To analyze the effect of intra aortic balloon counterpulsation(IABP) on patients with acute myocardial infarction(AMI) complicated with ardiogenic shock(CS) undergoing percutaneous coronary intervention(PCI) and the risk factors of postoperative in-hospital death. Methods: 105 patients with AMI complicated with CS who were treated in our hospital from June 2020 to May 2022 were selected. The patients treated with PCI directly were set as the control group(n=59 cases), and the patients treated with PCI assisted by IABP were set as the study group(n=46 cases). The postoperative cardiac indexes [left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVEDD) and left ventricular end systolic diameter(LVESD)], myocardial zymogram indexes [cardiac troponin T and troponin I, creatine kinase isoenzyme(CK-MB)] and postoperative major cardiovascular adverse events were compared between the two groups. The patients were divided into survival group(n=74) and death group(n=31)according to whether they survived at discharge. The clinical data of the two groups were compared, and the risk factors of in-hospital death were analyzed by multivariate logistic regression model. Results: The LVEF of the two groups after operation was increased, LVEDD and LVESD were decreased, and LVEF of the study group was higher than that of the control group, and LVEDD and LVESD were lower than those of the control group(P<0.05). The myocardial zymogram indexes of the two groups after operation were significantly decreased compared with those before operation, and the levels of troponin I, troponin T and CK-MB of the study group were lower than those of the control group(P<0.05). There were 5 cases of recurrent myocardial infarction and 7 cases of acute thrombosis of the control group after operation, 2 cases and 3 cases of the study group respectively(P>0.05). There were 23 deaths of the control group, and 8 deaths of the study group. The number of deaths of the study group was lower than that of the control group(P<0.05). The age, Killip grade ≥ grade III, hyperlipidemia, LVEF < 40%, proportion of TIMI blood flow grade ≤ grade II, leukocyte count and serum creatinine level of the death group were higher than those of the survival group, and systolic blood pressure, diastolic blood pressure, hemoglobin, troponin I,troponin T, CK-MB, LVEF and IABP assisted were lower than those in the survival group(P<0.05). Multivariate logistic regression analysis showed that age ≥ 65 years, Killip grade ≥ grade III, LVEF < 40% and TIMI blood flow grade ≤ grade II were the risk factors for in-hospital death of patients(P<0.05). Conclusion: IABP assisted supported PCI can effectively improve cardiac function in patients with AMI complicated with CS. Age ≥ 65 years, Killip grade ≥ grade III, LVEF <40%, TIMI blood flow grade ≤ grade II are the risk factors for in-hospital death. [ABSTRACT FROM AUTHOR]