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Chronic Dis Transl Med · Dec 2018
Percutaneous left ventricular assist device vs. intra-aortic balloon pump in patients with severe left ventricular dysfunction undergoing cardiovascular intervention: A meta-analysis.
- Fang-Bin Hu and Lian-Qun Cui.
- Department of Cardiology, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China.
- Chronic Dis Transl Med. 2018 Dec 1; 4 (4): 260-267.
ObjectiveAlthough controversial, the intra-aortic balloon pump (IABP) and percutaneous left ventricular assist device (PLVAD) are widely used for initial hemodynamic stabilization. We performed a meta-analysis to compare the clinical outcomes of these two devices in patients with severe left ventricular (LV) dysfunction undergoing percutaneous coronary intervention (PCI) or ventricular tachycardia (VT) ablation.MethodsMEDLINE, EMBASE, the Cochrane Registry of Controlled Trials, and reference lists of relevant articles were searched. We included randomized controlled trials (RCTs) and prospective observational studies. Meta-analysis was conducted using a random effects model.ResultsThe quantitative analysis included 4 RCTs and 2 observational studies. A total of 348 patients received PLVAD and 340 received IABP. Meta-analysis revealed that early mortality rates (in-hospital or 30-day) did not differ between the PLVAD and IABP groups (relative risk (RR) = 1.03, 95% confidence interval (CI) = 0.70-1.51, P = 0.89). Significant differences were observed between the two groups in the composite, in-hospital, non-major adverse cardiac and cerebrovascular events (MACCE) rate (RR = 1.30, 95% CI = 1.01-1.68, P = 0.04).ConclusionsCompared with IABP, PLVAD with active circulatory support did not improve early survival in those with severe left ventricular dysfunction undergoing either PCI or VT ablation, but increased the in-hospital non-MACCE rate.
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