title: Lack of intra-aortic balloon pump effectiveness in high-risk percutaneous coronary interventions without cardiogenic shock: a comprehensive meta-analysis of randomised trials and observational studies.
abstract: BACKGROUND
  Although controversial, using prophylactic intra-aortic balloon pump (IABP) in patients undergoing high-risk percutaneous coronary intervention (PCI) has been reported to be effective by numerous registry studies. However, conflicting findings were observed in observational studies (Obs.) and randomised controlled trials (RCTs).
  
  
  OBJECTIVE
  The purpose of this meta-analysis was to assess the impact of IABP on in-hospital deaths, major adverse cardiovascular events (MACCE), access-site complications and stroke in high-risk PCI cases from Obs. and RCTs published from 1st January, 1990 to 31st March, 2012 and indexed in PubMed.
  
  
  RESULTS
  We retrieved 1125 studies from the database; 11 studies compared the effects of IABP support, i.e., prophylactic administration (P-IABP) vs. no support (No-IABP), in high-risk patients undergoing PCI. These studies were included in the meta-analysis. We then calculated risk ratios (RRs) and risk differences (RDs) between the two groups of patients (P-IABP vs. No-IABP). We did not observe significant in-hospital mortality, MACCE, access-site complications or stroke differences in the RRs and RDs of the two groups.
  
  
  CONCLUSIONS
  The results suggest that PCI plus P-IABP support does not result in reduced in-hospital mortality or MACCE nor in significant higher access-site complications or stroke incidence compared with PCI alone in patients at high risk for peri-procedural PCI complications.
authors.affiliation: Department of Cardiovascular Disease, University of Rome, Tor Vergata, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Acconcia
authors.forename: Domenico
authors.initials: D
authors.lastname: Sergi
authors.forename: Alessia
authors.initials: A
authors.lastname: Romeo
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Flavia
authors.initials: F
authors.lastname: Chiarotti
authors.forename: Quintilio
authors.initials: Q
authors.lastname: Caretta
mesh_terms: D016208:Databases, Factual / Q000639:trends; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods*; D064887:Observational Studies as Topic / Q000379:methods; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods / Q000401:mortality*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012307:Risk Factors; D012770:Shock, Cardiogenic; D016896:Treatment Outcome
keywords: High-risk PCI; IABP; Meta-analysis; Primary PCI