Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Meta-Analysis and Trial Sequential Analysis Comparing Percutaneous Ventricular Assist Devices Versus Intra-Aortic Balloon Pump During High-Risk Percutaneous Coronary Intervention or Cardiogenic Shock

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Causes of Mortality in the Marfan Syndrome(from a Nationwide Register Study)

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Usefulness of Transcatheter Aortic Valve Implantation for Treatment of Pure Native Aortic Valve Regurgitation

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Xiao Chai Hu Tang, a herbal medicine, for chronic hepatitis B

    Research output: Contribution to journalReviewResearchpeer-review

  2. Acupuncture for chronic hepatitis B

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Exercise-Based Rehabilitation for Heart Failure: Cochrane Systematic Review, Meta-Analysis, and Trial Sequential Analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Saul A Rios
  • Claudio A Bravo
  • Michael Weinreich
  • Wilman Olmedo
  • Pedro Villablanca
  • Miguel Alvarez Villela
  • Harish Ramakrishna
  • Sameer Hirji
  • Octavio A Robles
  • Poonam Mahato
  • Christian Gluud
  • Deepak L Bhatt
  • Ulrich P Jorde
View graph of relations

The intra-aortic balloon pump (IABP) and percutaneous ventricular assist devices (pVAD) are commonly used in different clinical scenarios. The goal of this study was to carry out a meta-analysis and Trial Sequential Analysis (TSA) comparing the IABP versus pVAD (TandemHeart and the Impella) during high-risk percutaneous coronary intervention (PCI) or cardiogenic shock (CS). Using PubMed, Cochrane Central Register of Controlled Trials, and EMBASE we searched for randomized clinical trials (RCTs) and nonrandomized studies that compared pVAD versus IABP in patients who underwent high-risk PCI or with CS. We included 5 RCTs and 1 nonrandomized study comparing pVAD versus IABP. Based on the RCTs, we demonstrated no difference in short-term (6 months) (risk ratio [RR] 1.09, 95% confidence interval [CI] 0.79 to 1.52; p = 0.59) or long-term (12 months) (RR 1.00, 95% CI 0.57 to 1.76; p = 1.00) all-cause mortality. The use of pVAD seemed associated with more adverse events (acute kidney injury, limb ischemia, infection, major bleeding, and vascular injury) compared with IABP (RR 1.65, 95% CI 1.14 to 2.39; p = 0.008) but this was not supported by TSA (random-effects RR 1.66, 95% CI 0.89 to 3.09; p = 0.11; TSA-adjusted CI 0.13 to 21.3). In conclusion there were no differences in short or long-term mortality when using IABP versus pVAD for high-risk PCI or CS. IABP showed superiority over pVAD in terms of risk of harm. However, further RCTs are needed to establish more conclusively the role of these modalities of mechanical circulatory support during high-risk PCI or CS.

Original languageEnglish
JournalThe American journal of cardiology
VolumeS0002-9149
Issue number18
Pages (from-to)31429-2
ISSN0002-9149
DOIs
Publication statusPublished - 24 Jul 2018

ID: 55094770