Microaxial circulatory support for percutaneous coronary intervention: A systematic review and meta-analysis.
Publication/Presentation Date
6-1-2023
Abstract
BACKGROUND: Microaxial circulatory support devices have been used to support patients treated with percutaneous coronary intervention (PCI) for acute myocardial infarction complicated by cardiogenic shock (AMICS). The purpose of this systematic review and meta-analysis was to pool and analyze the existing evidence on the baseline characteristics, periprocedural data, and outcomes of microaxial support before and after PCI in AMICS.
METHODS: An electronic database search was performed to identify all cohort studies on Impella and PCI for cardiogenic shock in the English language. A total of five articles comprising 543 patients were included. These patients received microaxial support either before (pre-PCI) or after (post-PCI) undergoing PCI. Comparative analyses were done between both groups.
RESULTS: The mean patient age was 66 years [95% Confidence Interval (58-74)], and 22% (89/396) of patients were female. ST-elevation myocardial infarctions (MI) comprised 64% (44-80) of MIs and 50% (44-56) of MIs involved the left anterior descending artery. The mean number of diseased vessels was 2.21 (1.62-2.80). The mean left ventricular ejection fraction was 31% (23.4-38.6). The mean arterial pressure was 66.3 mm Hg (54.1-78.5). Mean serum lactate [6.1 mmol/L (3.3-8.9)] and serum creatinine [1.4 mg/dl (1.0-1.7)] were similar between groups. 30-day mortality was lower in the pre-PCI group [41% (34%-49%)] compared to the post-PCI group [61% (42%-77%), p < 0.01]. Pooled Kaplan-Meier analysis showed better early survival in the pre-PCI group (p < 0.001).
CONCLUSION: Patients presenting with AMICS were similar at baseline in both pre-PCI and post-PCI groups. Nevertheless, pre-PCI group showed better early survival compared to post-PCI group.
Volume
47
Issue
6
First Page
934
Last Page
942
ISSN
1525-1594
Published In/Presented At
Leon, S. A., Rosen, J. L., Ahmad, D., Austin, M. A., Vishnevsky, A., Rajapreyar, I. N., Ruggiero, N. J., Rame, J. E., Entwistle, J. W., Massey, H. T., & Tchantchaleishvili, V. (2023). Microaxial circulatory support for percutaneous coronary intervention: A systematic review and meta-analysis. Artificial organs, 47(6), 934–942. https://doi.org/10.1111/aor.14494
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
36691820
Department(s)
Administration and Leadership
Document Type
Article