Abstract 3203: Intra-aortic Balloon Pump does not Improve Cardiovascular Outcomes in Patients with Acute Myocardial Infarction: A Meta-Analysis
Background: Previous studies have shown conflicting results whether use of intra-aortic balloon pump (IABP) is beneficial in high risk patients with acute myocardial infarction (AMI). The aim of this study was to evaluate if the use of IABP in such patients improves cardiovascular (CV) mortality.
Methods: We performed a systematic literature search for prospective randomized and non-randomized studies and retrospective studies comparing the effects of IABP with no IABP in patients with AMI, with or without cardiogenic shock. Total of 11 studies (N=12,417) were identified. Heterogeneity of the studies was analyzed by Cochran’s Q statistics. Mantel-Haenszel fixed-effect model was used to calculate combined relative risks (RR) when studies were homogenous and the random effect model was used when the studies were heterogenic. A two-sided alpha error of < 0.05 was considered statistically significant.
Results: Meta-analysis of all studies revealed no improvement, in hospital morality (RR: 1.22 CI: 0.60 –2.51), re-infarction (RR: 0.81 CI: 0.30 –2.17), and recurrent ischemia (RR: 0.85 CI: 0.35–2.07) in IABP group. In fact IABP was found to significantly increase the risk of moderate bleeding (RR: 1.71 CI: 1.03–2.85 P<0.04) and major bleeding (RR: 4.01; CI: 2.66 – 6.06 P<0.0001). When analysis was restricted to only prospective randomized control trials, the results did not change, revealing no improvement in hospital mortality (RR:1.08 CI:0.70 –1.69), re-infarction (RR:0.71 CI:0.40 –1.26) and recurrent ischemia (RR:0.61 CI:0.24 –1.56) in IABP group.
Conclusion: IABP was not found to improve the CV outcomes in high risk patients with AMI when compared to conventional treatment.