[Mortality in patients with cardiogenic shock associated with the use of microaxial flow pump: a systematic review and meta-analysis].

Abstract

In this article we aim to evaluate the impact of the microaxial flow pump on mortality in patients with cardiogenic shock associated with acute myocardial infarction through a systematic review and meta-analysis of clinical trials and cohort studies. Patients with acute myocardial infarction, both with and without ST-segment elevation, associated with cardiogenic shock and treated with a microaxial flow pump, were included. Mortality data and implantation time of the device were reported. Patients with more than 24 hours of shock progression, those with other shock etiologies, patients with mechanical complications from acute myocardial infarction, and other comorbidity, were excluded. The search was conducted in PubMed and Web of Science databases for articles published from 2019 until November 10, 2024. Risk of bias was evaluated using the RoB 2 tool and the ROBINS-E, while statistical analysis was performed using Review Manager 5.4.1 software. A total of 1000 patients from five studies were included. The use of the microaxial flow pump was associated with a reduction in mortality compared to placebo (OR: 0.6; 95%CI: 0.42-0.85; p = 0.005). However, there were no significant differences in mortality related to the timing of the microaxial flow pump implantation (before, during, or after percutaneous coronary intervention) (OR: 0.85; 95%CI: 0.59-1.22; p = 0.37). Patients with cardiogenic shock have gained access to various treatment opportunities that were not available until recently. The results suggest that the microaxial flow pump is a therapeutic option in these patients with significant effects on mortality.