PMID- 36741852
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230207
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 9
DP  - 2022
TI  - Meta-analysis of extracorporeal membrane oxygenation in combination with 
      intra-aortic balloon pump vs. extracorporeal membrane oxygenation only in 
      patients with cardiogenic shock due to acute myocardial infarction.
PG  - 1104357
LID - 10.3389/fcvm.2022.1104357 [doi]
LID - 1104357
AB  - BACKGROUND: Incidence and mortality of cardiogenic shock (CS) in patients with 
      acute myocardial infarction (AMI) remain high despite substantial therapy 
      improvements in acute percutaneous coronary intervention over the last decades. 
      Unloading the left ventricle in patients with Veno-arterial extracorporeal 
      membrane oxygenation (VA-ECMO) can be performed by using an intra-aortic balloon 
      pumps' (IABP) afterload reduction, which might be especially beneficial in AMI 
      patients with CS. OBJECTIVE: The objective of this meta-analysis was to assess 
      the effect of VA-ECMO + IABP vs. VA-ECMO treatment on the mortality of patients 
      with CS due to AMI. METHODS: A systematic literature search was performed using 
      EMBASE, COCHRANE, and MEDLINE databases. Studies comparing the effect of VA-ECMO 
      + IABP vs. VA-ECMO on mortality of patients with AMI were included. Meta-analyses 
      were performed to analyze the effect of the chosen treatment on 
      30-day/in-hospital mortality. RESULTS: Twelve studies were identified by the 
      literature search, including a total of 5,063 patients, 81.5% were male and the 
      mean age was 65.9 years. One thousand one hundred and thirty-six patients 
      received treatment with VA-ECMO in combination with IABP and 2,964 patients 
      received VA-ECMO treatment only. The performed meta-analysis showed decreased 
      mortality at 30-days/in-hospital after VA-ECMO + IABP compared to VA-ECMO only 
      for patients with cardiogenic shock after AMI (OR 0.36, 95% CI 0.30-0.44, 
      P</=0.001). Combination of VA-ECMO + IABP was associated with higher rates of 
      weaning success (OR 0.29, 95% CI 0.16-0.53, P < 0.001) without an increase of 
      vascular access complications (OR 0.85, 95% CI 0.35-2.08, P = 0.72). CONCLUSION: 
      In this meta-analysis, combination therapy of VA-ECMO + IABP was superior to 
      VA-ECMO only therapy in patients with CS due to AMI. In the absence of randomized 
      data, these results are hypothesis generating only.
CI  - Copyright (c) 2023 Meertens, Tichelbacker, Macherey-Meyer, Heyne, Braumann, Niessen, 
      Baldus, Adler and Lee.
FAU - Meertens, Max M
AU  - Meertens MM
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Tichelbacker, Tobias
AU  - Tichelbacker T
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Macherey-Meyer, Sascha
AU  - Macherey-Meyer S
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Heyne, Sebastian
AU  - Heyne S
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Braumann, Simon
AU  - Braumann S
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Niessen, Stephan F
AU  - Niessen SF
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Baldus, Stephan
AU  - Baldus S
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Adler, Christoph
AU  - Adler C
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
FAU - Lee, Samuel
AU  - Lee S
AD  - Faculty of Medicine, Clinic III for Internal Medicine, University Hospital 
      Cologne, University of Cologne, Cologne, Germany.
LA  - eng
PT  - Journal Article
DEP - 20230118
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC9889933
OTO - NOTNLM
OT  - IABP
OT  - VA-ECMO
OT  - acute coronary syndrome (ACS)
OT  - cardiogenic shock
OT  - meta-analysis
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/02/07 06:00
MHDA- 2023/02/07 06:01
PMCR- 2022/01/01
CRDT- 2023/02/06 03:36
PHST- 2022/11/21 00:00 [received]
PHST- 2022/12/29 00:00 [accepted]
PHST- 2023/02/06 03:36 [entrez]
PHST- 2023/02/07 06:00 [pubmed]
PHST- 2023/02/07 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2022.1104357 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2023 Jan 18;9:1104357. doi: 10.3389/fcvm.2022.1104357. 
      eCollection 2022.