2023
DOI: 10.3389/fcvm.2022.1104357
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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

Abstract: BackgroundIncidence 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.ObjectiveThe objective of this m… Show more

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Cited by 8 publications
(3 citation statements)
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“…A recent meta-analysis of retrospective data has demonstrated that combination therapy of VA-ECMO and IABP in patients with cardiogenic shock due to acute MI may result in a reduction in mortality. 35 It is important to note that both the EURO-SHOCK and ECLS-SHOCK I trials were based on small sample sizes, with a combined population of 77 patients, and, therefore, the results should be interpreted with caution.…”
Section: Discussionmentioning
confidence: 99%
“…A recent meta-analysis of retrospective data has demonstrated that combination therapy of VA-ECMO and IABP in patients with cardiogenic shock due to acute MI may result in a reduction in mortality. 35 It is important to note that both the EURO-SHOCK and ECLS-SHOCK I trials were based on small sample sizes, with a combined population of 77 patients, and, therefore, the results should be interpreted with caution.…”
Section: Discussionmentioning
confidence: 99%
“…In selected patients with CS, there might be a benefit in using IABP for LV decompression during VA-ECMO support at a relatively low additive risk. 37,57,66,67,70,71 The ANCHOR trial (Assessment of ECMO in Acute Myocardial Infarction Cardiogenic Shock; NCT04184635), the first adequately powered RCT comparing VA-ECMO combined with IABP and optimal medical treatment alone in patients with AMI-CS, is currently underway (Table 3). Although this RCT is not specifically designed to prove an additive effect of IABP support, it will potentially clarify if LV venting can overcome some of the limitations of VA-ECMO therapy to facilitate better outcomes.…”
Section: Strategies For LV Unloading During Va-ecmomentioning
confidence: 99%
“…In a recent meta-analysis, conducted on twelve studies and 5063 patients, Merteens MM et al have demonstrated that the combination therapy of VA-ECMO + IABP is superior to VA-ECMO only in patients with CS due to AMI [ 26 ]. They showed decreased in-hospital mortality at 30 days after VA-ECMO + IABP when compared to VA-ECMO alone for patients with CS after AMI (OR 0.36, 95% CI 0.30–0.44, p ≤ 0.001).…”
Section: The Role Of Left Ventricular Unloading Systems During Eclsmentioning
confidence: 99%