{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T22:41:34Z","timestamp":1770331294192,"version":"3.49.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Despite technological advancements, mortality remains high in patients with myocardial infarction complicated by cardiogenic shock. Impella is increasingly used as an adjunct to standard treatment due to its hemodynamic benefits, though mixed study results limit its adoption. This meta-analysis aims to clarify Impella\u2019s efficacy by focusing on high-quality data from RCTs and cohort studies.<\/jats:p>\n                  <jats:p>A comprehensive literature search was conducted for randomized controlled trials and cohort studies comparing Impella with intra-aortic balloon pump (IABP) and extracorporeal membrane oxygenation (ECMO). Assessed metrics included mortality, clinical events, and hematologic markers. Data was analyzed using the Mantel-Haenszel random-effects model.<\/jats:p>\n                  <jats:p>Of 787 articles, 12 studies (4918 patients) met the inclusion criteria. Impella groups showed significant increases in thrombosis risk (RR: 4.94) and had a higher bleeding risk compared to IABP (RR: 1.98) but a lower risk compared to ECMO (RR: 0.66). All other comparisons did not reach statistical significance.<\/jats:p>\n                  <jats:p>Despite updated data and a stringent quality threshold, the hemodynamic benefits of Impella and the device\u2019s risk of thrombosis and bleeding were high. Future trials should emphasize patient selection, timing of placement, and operator proficiency to evaluate Impella\u2019s efficacy and safety better.<\/jats:p>","DOI":"10.1097\/hpc.0000000000000409","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:00:28Z","timestamp":1770289228000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impella in Cardiogenic Shock: An Updated Meta-Analysis"],"prefix":"10.1097","author":[{"given":"Ryan","family":"Berry","sequence":"first","affiliation":[{"name":".Authority Health, Detroit Medical Center - Sinai Grace, Michigan State University, Detroit, MI, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mobeen","family":"Haider","sequence":"additional","affiliation":[{"name":".Department of Cardiology, West Virginia University, Morgantown, WV, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prakash","family":"Upreti","sequence":"additional","affiliation":[{"name":".Sands Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Hamza","sequence":"additional","affiliation":[{"name":".Guthrie Medical Center, Cortland, NY, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junaid","family":"Mir","sequence":"additional","affiliation":[{"name":".University of Missouri, Columbia, MO, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krutarth","family":"Pandya","sequence":"additional","affiliation":[{"name":".Cleveland Clinic, Cleveland, OH, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mubashar","family":"Karamat","sequence":"additional","affiliation":[{"name":".Ascension Saint Francis Medical Center, Evanston, IL, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munis","family":"Ahmed","sequence":"additional","affiliation":[{"name":".Springfield Regional Medical Center, Springfield, OH, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Azfar","family":"Bilal","sequence":"additional","affiliation":[{"name":".Wayne State University\/ DMC-Sinai Grace, Detroit, MI, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasemin","family":"Bahar","sequence":"additional","affiliation":[{"name":".Wayne State University, Detroit, MI, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usman","family":"Naseer","sequence":"additional","affiliation":[{"name":".Department of Cardiology, University of South Dakota, Sanford School of Medicine, SD, USA ()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mowaffak","family":"Alraiyes","sequence":"additional","affiliation":[{"name":".Wayne State University \/ Detroit Medical Center, Cardiovascular Institute, Detroit, MI, USA ()()"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M Chadi","family":"Alraies","sequence":"additional","affiliation":[{"name":".Wayne State University \/ Detroit Medical Center, Cardiovascular Institute, Detroit, MI, USA ()()"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2026,1,30]]},"container-title":["Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/HPC.0000000000000409","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:00:29Z","timestamp":1770289229000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/HPC.0000000000000409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1097\/hpc.0000000000000409","relation":{},"ISSN":["1535-2811"],"issn-type":[{"value":"1535-2811","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,30]]}}}