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Effect of intra-aortic balloon pump with veno-arterial extracorporeal membrane oxygenation in acute myocardial infarction with cardiogenic shock: A meta-analysis

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机构: [1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China. [2]Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
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关键词: ECMO intra-aortic balloon cardiac shock short-term mortality meta-analysis

摘要:
The effectiveness of a concomitant intra-aortic balloon pump (IABP) with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) intervention in acute myocardial infarction with cardiogenic shock (AMICS) patients is contested in the literature. This study sought to compare short-term mortality weaning rate from VA-ECMOin AMICS cases.We conducted a literature review and compared the primary and secondary endpoints in the following treatment groups of AMICS patients: (1) VA-ECMO plus IABP vs. IABP alone and (2) VA-ECMO plus IABP vs. VA-ECMO alone. The primary endpoint was in-hospital all-cause mortality; while 30-days mortality, weaning from VA-ECMO, and vascular complications comprised secondary endpoints.VA-ECMO concomitant with IABP was administered to 3,580 (76.4%) patients, while IABP alone and VA-ECMO alone treatments accounted for 1.7% and 21.9% of the patients, respectively. We found that in-hospital mortality was significantly lower in patients treated with VA-ECMO plus IABP vs. VA-ECMO alone (odds ratio (OR) = 0.52; 95% Confidence Interval (CI) = 0.21-1.31; I-squared statistic (I2 = 30%) or IABP alone (OR = 0.20; 95% CI = 0.08-0.55; I2 = 0%). Additionally, 30-days mortality was significantly lower in patients treated with VA-ECMO plus IABP vs. VA-ECMO alone (OR = 0.31; 95% CI = 0.25-0.40; I2 = 0%) or IABP alone (OR = 0.24; 95% CI = 0.11-0.50; I2 = 0%). A significant difference was observed in weaning from VA-ECMO in patients treated with VA-ECMO plus IABP vs. VA-ECMO alone (OR = 1.91; 95% CI = 1.09-3.33; I2 = 0%).In-hospital and 30-days mortality were significantly lower in AMICS patients treated with VA-ECMO plus IABP vs. VA-ECMO alone or IABP alone. VA-ECMO with concomitant IABP could increase the proportion of patients weaned from VA-ECMO, significantly reducing in-hospital mortality, without increasing complications.

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出版当年[2022]版:
大类 | 4 区 医学
小类 | 4 区 心脏和心血管系统 4 区 外周血管病
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 心脏和心血管系统 4 区 外周血管病
JCR分区:
出版当年[2021]版:
Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Q4 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Q4 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
通讯作者:
通讯机构: [1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China. [2]Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
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