LAUSR

1. Despite early revascularization, the mortality of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) remains high. 2. Mechanical circulation support devices (MCS) are widely utilized in clinical due to unloading left ventricle and augmenting cardiac output. 3. Whether left ventricular assist device (LVAD) including TandemHeart and Impella is superior to Intra-aortic balloon pump (IABP) for AMI-CS remains unclear. To investigate the efficacy and safety of LVAD versus IABP for AMI-CS. 1. We searched the relevant literature on PUBMED, EMBASE and Cochrane Library. 2. The primary endpoint was 30-day mortality. The secondary endpoints were in-hospital myocardial infarction (MI), stent thrombosis (ST), stroke, sepsis, major bleeding and limb ischemia. 3. Two investigators performed the studies selection and data extraction independently. 4. The quality of randomized controlled trials and observational studies was assessed by using the Cochrane Collaboration's tool and Newcastle-Ottawa Scale respectively. 5. Results were analyzed by computing pooled risk ratios (RR) with 95% Confidence Intervals (CIs). 1. The process of literature search strategy is shown in Figure 1. 2. Main characteristics of the included studies can be seen in Table 1. 3. There was no significant difference in 30-day mortality (RR:0.97, 95% CI:0.80–1.17, P=0.76), in-hospital MI (RR:0.64, 95% CI:0.22–1.85, P=0.41), ST (RR:0.74, 95% CI:0.13–4.12, P=0.73), stroke (RR:1.36, 95% CI:0.37–4.94, P=0.64) and sepsis (RR:1.30, 95% CI:0.54–3.13, P=0.56) between LVAD and IABP group. However, the incidences of in-hospital major bleeding (RR:2.61,95% CI:1.61–4.23, P=0.0001) and limb ischemia (RR:4.91, 95% CI:2.07–11.64, P=0.0003) were significantly higher in LVAD than IABP group. LVAD was not associated with reduced 30-day mortality but with increased in-hospital major bleeding and limb ischemia for patients with AMI-CS compared with IABP. Figure 1 Type of funding source: Public Institution(s). Main funding source(s): National 135 Key Research and Development Program in 2016