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Background:Current literature recommends weaning intra‐aortic balloon pump (IABP) support prior to discontinuation. To date, no studies have compared various weaning strategies for safety or efficacy. This study was designed to evaluate the impact of weaning on in‐hospital clinical outcomes.Methods:From 5/1/07 through 5/1/09 429 patients receiving IABP therapy were retrospectively identified using CPT1 billing codes. The study population and clinical outcomes analysis were stratified by use of weaning protocols versus immediate discontinuation of the IABP. In a subset analysis the patients receiving weaning protocols prior to IABP discontinuation were stratified for further analysis of clinical outcomes by whether they had received 1:3 ratio counterpulsation during their wean or whether they only received 1:2 counterpulsation prior to IABP discontinuation. These groups were analyzed for differences in primary and secondary end‐points....