{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:41Z","timestamp":1789535081344,"version":"build-2803163510"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Mechanical circulatory support (MCS) is increasingly used during complex high\u2010risk indicated percutaneous coronary intervention, yet whether different support strategies improve clinical outcomes remains uncertain. We sought to compare the efficacy and safety of individual MCS strategies with standard care and with each other at short\u2010 and long\u2010term follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This frequentist random\u2010effects network meta\u2010analysis included randomized trials of patients undergoing nonemergent complex high\u2010risk indicated percutaneous coronary intervention and comparing percutaneous left ventricular assist devices, intra\u2010aortic balloon pump, venoarterial extracorporeal membrane oxygenation, or standard care. The primary efficacy outcome was major adverse cardiovascular events. Secondary outcomes included death, myocardial infarction, stroke, or repeat revascularization, and periprocedural major adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Eight trials (n=1856) were included. At 30\u2009days, no MCS was associated with lower major adverse cardiovascular events compared with standard care, though percutaneous left ventricular assist devices (risk ratio [RR] 0.30, 95% CI 0.10\u20130.90) and intra\u2010aortic balloon pump (RR 0.26, 95% CI 0.07\u20130.90) reduced periprocedural major adverse events. At a weighted mean of 10.8 months, no significant differences in major adverse cardiovascular events were observed with percutaneous left ventricular assist devices (incidence rate ratio 0.79; 95% CI 0.47\u20131.35), intra\u2010aortic balloon pump (incidence rate ratio 0.89, 95% CI 0.52\u20131.54), or venoarterial extracorporeal membrane oxygenation (incidence rate ratio 1.47, 95% CI 0.64\u20133.40) compared with standard care. Consistently, no MCS strategy reduced death, myocardial infarction, stroke, or repeat revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients undergoing complex high\u2010risk indicated percutaneous coronary intervention, MCS did not improve clinical outcomes, despite fewer periprocedural adverse events with percutaneous left ventricular assist devices and intra\u2010aortic balloon pump. These findings do not support routine prophylactic use and suggest that MCS should be limited to selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.052609","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:55:51Z","timestamp":1788965751000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanical Circulatory Support for Complex High\u2010Risk Indicated Percutaneous Coronary Intervention: Network Meta\u2010Analysis of Randomized Trials"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1951-1981","authenticated-orcid":false,"given":"Kamil","family":"Bujak","sequence":"first","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]},{"name":"Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia","place":["Katowice, Poland"]},{"name":"Medical University of Silesia","place":["Katowice, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5467-7402","authenticated-orcid":false,"given":"Claudio","family":"Laudani","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9008-3011","authenticated-orcid":false,"given":"Daniele","family":"Giacoppo","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5434-607X","authenticated-orcid":false,"given":"Marco","family":"Spagnolo","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9432-9314","authenticated-orcid":false,"given":"Maria Sara","family":"Mauro","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3536-8341","authenticated-orcid":false,"given":"Luigi","family":"Cutore","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3583-3331","authenticated-orcid":false,"given":"Giacinto","family":"Di Leo","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3974-3878","authenticated-orcid":false,"given":"Simone","family":"Finocchiaro","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2926-9428","authenticated-orcid":false,"given":"Antonio","family":"Greco","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. Rodolico\u2010San Marco\u201d, University of Catania","place":["Catania, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5156-7723","authenticated-orcid":false,"given":"Davide","family":"Capodanno","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero\u2010Universitaria Policlinico \u201cG. 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