Abstract
BackgroundCardiogenic 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. ObjectiveThis meta-analysis aims to evaluate the comparative effectiveness of Impella and IABP in managing CS-AMI, exploring mortality and adverse events. MethodsA 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. ResultsImpella 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). ConclusionsIn unselected CS-AMI patients, Impella usage is associated with significantly higher mortality and major bleeding.
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