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- Title
Efficacy and safety of extracorporeal membrane oxygenation for cardiogenic shock complicating myocardial infarction: a systematic review and meta-analysis.
- Authors
Elsaeidy, Ahmed Saad; Taha, Amira Mohamed; Abuelazm, Mohamed; Soliman, Youssef; Ali, Mohamed Ahmed; Alassiri, Abdullah K.; Shaikhkhalil, Hosam; Abdelazeem, Basel
- Abstract
Background: Extracorporeal membrane oxygenation (ECMO) has been presented as a potential therapeutic option for patients with cardiogenic shock complicating myocardial infarction (CS-MI). We aimed to investigate the efficacy and safety of ECMO in CS-MI. Methods: A systematic review and meta-analysis synthesizing evidence from randomized controlled trials obtained from PubMed, Embase, Cochrane, Scopus, and Web of Science until September 2023. We used the random-effects model to report dichotomous outcomes using risk ratio and continuous outcomes using mean difference with a 95% confidence interval. Finally, we implemented a trial sequential analysis to evaluate the reliability of our results. Results: We included four trials with 611 patients. No significant difference was observed between ECMO and standard care groups in 30-day mortality with pooled RR of 0.96 (95% CI: 0.81–1.13, p = 0.60), acute kidney injury (RR: 0.65, 95% CI: 0.41–1.03, p = 0.07), stroke (RR: 1.16, 95% CI: 0.38–3.57, p = 0.80), sepsis (RR: 1.06, 95% CI: 0.77–1.47, p = 0.71), pneumonia (RR: 0.99, 95% CI: 0.58–1.68, p = 0.96), and 30-day reinfarction (RR: 0.95, 95% CI: 0.25–3.60, p = 0.94). However, the ECMO group had higher bleeding events (RR: 2.07, 95% CI: 1.44–2.97, p < 0.0001). Conclusion: ECMO did not improve clinical outcomes compared to the standard of care in patients with CS-MI but increased the bleeding risk.
- Subjects
CARDIOGENIC shock; MYOCARDIAL infarction; EXTRACORPOREAL membrane oxygenation; ACUTE kidney failure; SEQUENTIAL analysis
- Publication
BMC Cardiovascular Disorders, 2024, Vol 24, Issue 1, p1
- ISSN
1471-2261
- Publication type
Article
- DOI
10.1186/s12872-024-03917-9