Effects of Intra-Aortic Balloon Counterpulsation Pump on Mortality of Acute Myocardial Infarction

<div><p>Background</p><p>Several randomized controlled trials (RCTs) have evaluated the effect of intra-aortic balloon counterpulsation pump(IABP) on the mortality of acute myocardial infarction (AMI).</p><p>Objectives</p><p>To analyze the relevant RCT data on the effect of IABP on mortality and the occurrence of bleeding in AMI.</p><p>Data Sources</p><p>Published 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.</p><p>Study Eligibility Criteria</p><p>Randomized clinical trials comparing IABP to controls as treatment for AMI.</p><p>Participants</p><p>Patients with AMI.</p><p>Synthesis Methods</p><p>The 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.</p><p>Results</p><p>Ten 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.</p><p>Conclusions</p><p>IABP 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.</p></div

Funnel plot of mortality within 6–12 months.

<p>Funnel plot of mortality within 6–12 months.</p

Characteristics of the included articles.

<p>AR:after randomization; CS:cardiogenic shock; IABP:intra-aortic balloon counterpulsation pump; NR, not reported; PTCA:percutaneous transluminal coronary angioplasty; TT: thrombolytic therapy; U, Unclear.</p><p>Characteristics of the included articles.</p

Forest plot of studies evaluating curative effect of IABP in mortality within 6–12 months.

<p>Forest plot of studies evaluating curative effect of IABP in mortality within 6–12 months.</p

Forest plot of studies evaluating curative effect of IABP in bleeding events.

<p>Forest plot of studies evaluating curative effect of IABP in bleeding events.</p

Methodological quality assessment of the included articles.

<p>N:No; U:Unclear; Y:Yes.</p><p>Methodological quality assessment of the included articles.</p

Forest plot of studies evaluating curative effect of IABP in mortality within 2 months.

<p>Forest plot of studies evaluating curative effect of IABP in mortality within 2 months.</p