{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T15:21:28Z","timestamp":1771946488709,"version":"3.50.1"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"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":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute myocardial infarction\u2010related cardiogenic shock (AMICS) is a severe complication associated with exceedingly high mortality rates. While mechanical circulatory support (MCS) has emerged as a potential intervention, the evidence base for independent MCS use remains weak. In contrast, systematic reviews of observational studies have revealed significant mortality reduction when a combination of MCS was used: VA\u2010ECMO in conjunction with a left ventricular (LV) unloading device (Impella or IABP). The ongoing dilemma concerning the selection between two LV unloading devices (VA\u2010ECMO\u2009+\u2009Impella vs. VA\u2010ECMO\u2009+\u2009IABP) warrants further investigation and clarification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This is the first systematic review and meta\u2010analysis assessing the short\u2010term efficacy and safety of VA\u2010ECMO\u2009+\u2009Impella versus VA\u2010ECMO\u2009+\u2009IABP in treatment of AMICS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search was performed on the EMBASE, MEDLINE, and Cochrane databases. Studies reporting the short\u2010term (30\u2010day\/inpatient) mortality and complications of adult patients with AMICS treated with VA\u2010ECMO\u2009+\u2009Impella and VA\u2010ECMO\u2009+\u2009IABP were included. Subgroup analysis was performed including studies with ACS predominant CS (CS etiology 100% by AMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four observational studies with 14,247 patients were included. There was no significant difference in mortality between VA\u2010ECMO\u2009+\u2009Impella and VA\u2010ECMO\u2009+\u2009IABP (56.5% vs. 66.5%; OR, 0.90; 95% CI, 0.79\u22121.02; <jats:italic>p<\/jats:italic>\u2009=\u20090.09). However, VA\u2010ECMO\u2009+\u2009Impella was associated with significantly lower mortality in patients with ACS predominant CS (53.2% vs. 67.7%; OR, 0.72; 95% CI, 0.62\u22120.85; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). VA\u2010ECMO\u2009+\u2009Impella was concomitantly associated with a significantly higher risk of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When comparing LV unloading devices in patients with AMICS requiring a combination of MCS, VA\u2010ECMO\u2009+\u2009Impella was superior in mortality reduction only in the cohort where 100% of CS was caused by AMI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31369","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T07:00:02Z","timestamp":1735023602000},"page":"650-661","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Systematic Review and Meta\u2010Analysis of the Efficacy and Safety of Combined Mechanical Circulatory Support in Acute Myocardial Infarction Related Cardiogenic Shock"],"prefix":"10.1002","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7653-8825","authenticated-orcid":false,"given":"Bing Wei Thaddeus","family":"Soh","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital Waterford Waterford Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8364-1748","authenticated-orcid":false,"given":"Carlos Sebastian","family":"Gracias","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Limerick Limerick Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afshan","family":"Dean","sequence":"additional","affiliation":[{"name":"The Usher Institute, College of Medicine &amp; Veterinary Medicine The University of Edinburgh Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jathinder","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Waterford Waterford Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solomon","family":"Asgedom","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Waterford Waterford Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajjad","family":"Matiullah","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Waterford Waterford Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Owens","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Waterford Waterford Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872619894254"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.04.004"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1922"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1710261"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872617741735"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28329"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx406"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.613596"},{"key":"e_1_2_12_10_1","first-page":"1184","volume-title":"Heart Disease: A Textbook of Cardiovascular Medicine","author":"Em A.","year":"1997"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht248"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2021.11.006"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12175576"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1012052"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676369"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29834"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036691"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208410"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307227"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312572"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.065"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.022"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2019.10.005"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048792"},{"key":"e_1_2_12_25_1","first-page":"134","article-title":"Comparison of ECMO vs ECpella in Patients With Non\u2010Post\u2010Pericardiotomy Cardiogenic Shock: An Updated Meta\u2010Analysis. 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