{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T05:11:35Z","timestamp":1787375495850,"version":"build-2736575974"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Mortality from cardiogenic shock complicating acute myocardial infarction (AMI-CS) remains high, despite the increasing mechanical circulatory support (MCS) use in clinical practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We undertook a systematic review and meta-analysis of trials assessing MCS in adults with AMI-CS. We searched Medline, EMBASE, CENTRAL, Web of Science, and Scopus from inception to May 2024. We evaluated the effect of each intervention on early mortality using a random-effects network meta-analysis of odds ratios (ORs). Safety outcomes included stroke, bleeding, and sepsis. Fourteen trials randomizing 1858 patients were included: intra-aortic balloon pump (IABP) vs. medical therapy (four trials, n = 748 patients), veno-arterial extra-corporeal membrane oxygenation (VA-ECMO) vs. No VA-ECMO (four trials, n = 568 patients), percutaneous ventricular assist device (pVAD) vs. No pVAD (six trials, n = 542 patients). No MCS device showed a significant effect on early mortality vs. initial medical therapy {IABP (OR 0.87, 95% CI 0.66\u20131.15), VA-ECMO (OR 0.91, 95% CI 0.65\u20131.27), pVAD (OR 0.80, 95% CI 0.56\u20131.14), and P (inconsistency) = 0.76}. VA-ECMO and pVAD were associated with increased major bleeding [OR 2.81 (95% CI 1.68\u20134.71) and OR 5.13 (95% CI 1.87\u201314.04), respectively]. Higher rates of stroke and sepsis were noted with pVAD. No significant safety concerns were identified with IABP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The mortality benefit of MCS devices in AMI-CS remains uncertain. Using such devices may be associated with increased risks, including major bleeding, stroke, and sepsis. Current evidence does not support the routine use of MCS devices in the management of AMI-CS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeaf091","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T18:36:13Z","timestamp":1753814173000},"source":"Crossref","is-referenced-by-count":2,"title":["Mechanical circulatory support for infarct-related cardiogenic shock: a systematic review, pairwise and network meta-analysis"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7744-6121","authenticated-orcid":false,"given":"Zaran","family":"Butt","sequence":"first","affiliation":[{"name":"MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London , WC1V 6LJ London ,","place":["UK"]},{"name":"Department of Cardiology, Connolly Hospital , Blanchardstown, D15 X40D Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Connolly Hospital , Blanchardstown, D15 X40D Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Connolly Hospital , Blanchardstown, D15 X40D Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Daly","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Connolly Hospital , Blanchardstown, D15 X40D Dublin ,","place":["Ireland"]},{"name":"Royal College of Surgeons in Ireland, University of Medicine and Health Sciences , 123 St. Stephen\u2019s Green, D02 YN77 Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Connolly Hospital , Blanchardstown, D15 X40D Dublin ,","place":["Ireland"]},{"name":"Royal College of Surgeons in Ireland, University of Medicine and Health Sciences , 123 St. Stephen\u2019s Green, D02 YN77 Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Gentry-Maharaj","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London , WC1V 6LJ London ,","place":["UK"]},{"name":"Department of Women\u2019s Cancer, EGA Institute for Women\u2019s Health, University College London , WC1E 6DE London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0648-0992","authenticated-orcid":false,"given":"Peter J","family":"Godolphin","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London , WC1V 6LJ London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"2025081215493389500_oeaf091-B1","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1002\/ejhf.1566","article-title":"Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study","volume":"21","author":"Helgestad","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2025081215493389500_oeaf091-B2","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1038\/s41569-022-00796-5","article-title":"Temporary mechanical circulatory support devices: practical considerations for all stakeholders","volume":"20","author":"Salter","year":"2023","journal-title":"Nat Rev Cardiol"},{"key":"2025081215493389500_oeaf091-B3","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/eurheartj\/14.1.71","article-title":"Intra-aortic balloon counterpulsation improves survival in cardiogenic shock complicating acute myocardial infarction","volume":"14","author":"Waksman","year":"1993","journal-title":"Eur Heart J"},{"key":"2025081215493389500_oeaf091-B4","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1097\/CCM.0b013e3181e8acf7","article-title":"Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with ST-segment elevation myocardial infarction complicated with profound cardiogenic shock","volume":"38","author":"Sheu","year":"2010","journal-title":"Crit Care Med"},{"key":"2025081215493389500_oeaf091-B5","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1056\/NEJM199908263410901","article-title":"Early revascularization in acute myocardial infarction complicated by cardiogenic shock. 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