{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:57:42Z","timestamp":1788472662764,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T00:00:00Z","timestamp":1645228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aim to define whether the timing of microaxial left ventricular assist device (IMLVAD) implantation might impact on mortality in acute myocardial infarction (AMI) cardiogenic shock (CS) patients who underwent primary percutaneous coronary intervention (PPCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite the widespread use of PPCI, mortality in patients with AMI and CS remains high. Mechanical circulatory support is a promising bridge to recovery strategy, but evidence on its benefit is still inconclusive and the optimal timing of its utilization remains poorly explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared clinical outcomes of upstream IMLVAD use before PPCI versus bailout use after PPCI in patients with AMI CS. A systematic review and meta\u2010analysis of studies comparing the two strategies were performed. Effect size was reported as odds ratio (OR) using bailout as reference group and a random effect model was used. Study\u2010level risk estimates were pooled through the generic inverse variance method (random effect model).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 11 observational studies were identified, including a pooled population of 6759 AMI\u2010CS patients. Compared with a bailout approach, upstream IMLVAD was associated with significant reduction of 30\u2010day (OR\u2009=\u20090.65; 95% confidence interval [CI]\u2009=\u20090.51\u20130.82; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200943%, adjusted OR\u2009=\u20090.54; 95% CI\u2009=\u20090.37\u20130.59; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20093%, test for subgroup difference <jats:italic>p<\/jats:italic>\u2009=\u20090.30), 6\u2010month (OR\u2009=\u20090.51; 95% CI\u2009=\u20090.27\u20130.96; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200966%), and 1\u2010year (OR\u2009=\u20090.56; 95% CI\u2009=\u20090.39\u20130.79; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%) all\u2010cause mortality. Incidence of access\u2010related bleeding, acute limb ischemia and transfusion outcomes were similar between the two strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with AMI\u2010CS undergoing PPCI, upstream IMLVAD was associated with reduced early and midterm all\u2010cause mortality when compared with a bailout strategy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30137","type":"journal-article","created":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T08:23:39Z","timestamp":1645259019000},"page":"998-1005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Timing of mechanical circulatory support during primary angioplasty in acute myocardial infarction and cardiogenic shock: Systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-3408","authenticated-orcid":false,"given":"Federico","family":"Archilletti","sequence":"first","affiliation":[{"name":"Department of Innovative Technologies in Medicine &amp; Odontology, Institute of Cardiology \u201cG. d'Annunzio\u201d University  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livio","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Department Cath Lab, Ospedale SS. Annunziata, ASL 2 Abruzzo  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7502-8049","authenticated-orcid":false,"given":"George D.","family":"Dangas","sequence":"additional","affiliation":[{"name":"The Zena and Michael A. Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Ricci","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences \u201cG. d'Annunzio\u201d University  Chieti Italy"},{"name":"Department of Clinical Sciences Lund University  Malm\u00f6 Sweden"},{"name":"Department of Cardiology Casa di Cura Villa Serena  Citt\u00e0 Sant'Angelo Pescara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Benedetto","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery \u201cG D'Annunzio\u201d University  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Radico","sequence":"additional","affiliation":[{"name":"Department of Innovative Technologies in Medicine &amp; Odontology, Institute of Cardiology \u201cG. d'Annunzio\u201d University  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Gallina","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences \u201cG. d'Annunzio\u201d University  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Rossi","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Department Cath Lab, Ospedale SS. 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