Percutaneous Left Ventricular Assist Devices Vs Intra-aortic Ballon Pump For Treatment Of Cardiogenic Shock:A Meta-analysis

Objective : We performed a meta-analysis to compared safety and efficacy of percutaneous left ventricular assist devices with intra-aortic balloon pump in patients with cardiogenic shock.Methods : A comprehensive literature search was performed in Pub Med,Web of Science,Embase,CNKI,Vip databases for all controlled trials and Observational cohort studies using percutaneous left ventricular assist devices(p VADs)or intra-aortic balloon pump(IABP)in patients with cardiogenic shock(CS),which updated to December 30,2019.The study endpoints included mortality,hemodynamics,and the incidence of adverse events.The Quality of the literature was assessed with Cochrane Systematic Review and the Newcastle Ottawa Scale.Then meta-analysis was performed used Review Manager5.3 and Stata 15.1.Results:1.The study included 14 literatures with 1926 patients.Meta analysis revealed that there is no difference in mortality,stroke complications and acute renal dysfunction between p VAD and IABP in patients with cardiogenic shock(CS).2.Compared with IABP,p VAD were associated with a better hemodynamicin patients with CS(MD=0.42,95%CI:0.23-0.62,Z=4.27,P<0.01).3.The use of p VAD seemed had more adverse events like major bleeding(OR=2.79,95%CI:1.42-5.48,P<0.01),limb ischemia(OR=4.32,95%CI:2.15-8.68,P<0.01),infection(OR=2.81,95%CI:1.31-3.62,P<0.01).Conclusions:1.No difference in all-cause mortality、stroke and acute renal dysfunction between p VAD and IABP in patients with CS.2.Compared with IABP,p VAD were associated with a better hemodynamics in patients with CS.3.Compared with p VAD,IABP associated with less adverse events like major bleeding、limb ischemia、infection in patients with CS.