MI2AMI-CS：比较急性心肌梗死相关心源性休克中 Impella 和 IABP 结局的荟萃分析。
MI2AMI-CS: A meta-analysis comparing Impella and IABP outcomes in Acute Myocardial Infarction-related Cardiogenic Shock.
机构信息
Cardiology Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria "Policlinico G. Martino", University of Messina, Messina, Italy.
Cardiology Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria "Policlinico G. Martino", University of Messina, Messina, Italy.
出版信息
Int J Cardiol. 2024 Nov 1;414:132411. doi: 10.1016/j.ijcard.2024.132411. Epub 2024 Jul 31.
BACKGROUND
Cardiogenic Shock (CS) complicating acute myocardial infarction (AMI) poses a significant mortality risk, suggesting the opportunity to implement effective mechanical circulatory support strategies. The comparative efficacy of Intra-Aortic Balloon Pump (IABP) and Impella in managing CS-AMI remains a subject of investigation.
OBJECTIVE
This meta-analysis aims to evaluate the comparative effectiveness of Impella and IABP in managing CS-AMI, exploring mortality and adverse events.
METHODS
A systematic search of major databases from inception to November 2023 identified eight studies, comprising 10,628 patients, comparing Impella and IABP in CS-AMI. Retrospective studies (preferably Propensity-matched) and Randomized Clinical Trials (RCTs) were included.
RESULTS
Impella use exhibited significantly higher mortality (57% vs. 46%; OR: 1.44, 95% CI: 1.29-1.60; p < 0.001) and major bleeding (30% vs 15%; OR: 2.93, 95% CI: 1.67-5.13; p < 0.001).
CONCLUSIONS
In unselected CS-AMI patients, Impella usage is associated with significantly higher mortality and major bleeding.
背景
急性心肌梗死（AMI）并发心源性休克（CS）会带来较高的死亡率，这提示我们有机会实施有效的机械循环支持策略。主动脉内球囊泵（IABP）和 Impella 在 CS-AMI 中的应用效果比较仍有待研究。
目的
本荟萃分析旨在评估 Impella 和 IABP 在 CS-AMI 中的应用效果，探讨死亡率和不良事件。
方法
系统检索了从创建到 2023 年 11 月的主要数据库，共纳入 8 项研究，涉及 10628 例 CS-AMI 患者，比较了 Impella 和 IABP 的应用效果。纳入了回顾性研究（最好是倾向评分匹配）和随机临床试验（RCT）。
结果
Impella 组的死亡率（57% vs. 46%；OR：1.44，95%CI：1.29-1.60；p<0.001）和大出血发生率（30% vs. 15%；OR：2.93，95%CI：1.67-5.13；p<0.001）均显著高于 IABP 组。
结论
在未经选择的 CS-AMI 患者中，Impella 的应用与更高的死亡率和大出血发生率相关。
Zotero 插件