Effects of intra-aortic balloon counterpulsation pump on mortality of acute myocardial infarction.

Liwen Ye,Qingwei Chen,Dazhi Ke,Wei Deng,Guiqion Li,Minming Zheng,Katriina Aalto-Setala

doi:10.1371/journal.pone.0108356

Abstract

BackgroundSeveral randomized controlled trials (RCTs) have evaluated the effect of intra-aortic balloon counterpulsation pump(IABP) on the mortality of acute myocardial infarction (AMI).ObjectivesTo analyze the relevant RCT data on the effect of IABP on mortality and the occurrence of bleeding in AMI.Data SourcesPublished RCTs on the treatment of AMI by IABP were retrieved in searches of Medline, EMBASE, Cochrane and other related databases. The last search was conducted on July 20, 2014.Study Eligibility CriteriaRandomized clinical trials comparing IABP to controls as treatment for AMI.ParticipantsPatients with AMI.Synthesis MethodsThe primary endpoint was mortality, and the secondary endpoint was bleeding events. To account for to heterogeneity, a random-effects model was used to analyze the study data.ResultsTen trials with a total population of 973 patients that were included in the analysis showed no significant difference in 2-month mortality between the IABP and the control groups. The 6-month mortality in the IABP group was not significantly lower than in the control group in the four RCTs that enrolled 59 AMI patients with CS. But in the four that enrolled AMI 66 patients without CS, the data showed opposite conclusion.ConclusionsIABP cannot reduce within 2 months and 6–12 months mortality of AMI patients with CS as well as within 2 months mortality of AMI patients without CS, but can reduce 6–12 months mortality of AMI patients without CS. In addition, IABP can increase the risk of bleeding.

Highlights

Intra-aortic balloon counterpulsation pump(IABP) can increase blood flow in the coronary artery and the brain while reducing afterload and cardiac oxygen consumption [1]
Study sample selection characteristics A total of 641 potentially eligible publications were retrieved during the searches, and 524 articles not associated with treatment of acute myocardial infarction (AMI) with IABP were excluded by browsing the title or abstract (Figure 1)
The 13 studies enrolled 2237 AMI patients; 1112 were treated with IABP and 1125 patients were not treated with IABP

Summary

Introduction

Intra-aortic balloon counterpulsation pump(IABP) can increase blood flow in the coronary artery and the brain while reducing afterload and cardiac oxygen consumption [1]. Because IABP can quickly improve the effect of patients’ clinical symptom, so this technology causes people’s attention. Numerous percutaneous circulation support equipments are applied, the effect of IABP in adjuvant therapy of AMI patients is still controversial. Some previous studies show that IABP benefits for high-risk patients with AMI, but most of these studies are non-randomized and retrospective, with serious selection bias and poor credibility. In some other studies, the effectiveness of IABP in adjuvant therapy for severe patients with AMI has not been ensured [14,18]. Several randomized controlled trials (RCTs) have evaluated the effect of intra-aortic balloon counterpulsation pump(IABP) on the mortality of acute myocardial infarction (AMI)

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