Intraaortic balloon pump in patients with cardiogenic shock complicating myocardial infarction. A systematic review and meta-analysis of randomized trials
Bibliographic record
Abstract
INTRODUCTION: Cardiogenic shock is associated with significant mortality, particularly when caused by myocardial infarction. Intraaortic balloon pump (IABP) is the primary hemodynamic adjunct in patients with cardiogenic shock; however, evidence suggests that IABP may not improve mortality in this population. METHODS: We conducted an electronic search of the Medline, EMBASE, and Cochrane trial registry databases. Two reviewers independently screened citations and identified eligible trials. The same reviewers abstracted data independently. We pooled the data using a fixed effect model and reported dichotomous outcomes as risk ratios (RRs) with 95% confidence intervals (CIs). Subsequently, we used the GRADE approach to judge the quality of evidence. RESULTS: We included 4 randomized trials with 735 patients. The use of IABP did not reduce the risk of death in patients with cardiogenic shock secondary to cardiac ischemia when compared with usual care (RR, 0.94; 95% CI, 0.79-1.13; P = 0.52; I² = 0%; moderate confidence). The use of IABP was not associated with an increased risk of stroke (RR, 0.77; 95% CI 0.22-2.69; P = 0.68; I² = 48%; very low confidence), limb ischemia (RR, 1.24; 95% CI, 0.59-2.59; P = 0.58; I² = 0%; low confidence), or major bleeding (RR, 0.76; 95% CI, 0.34-1.72; P = 0.52; I² = 0%; low confidence). CONCLUSIONS: The use of IABP in patients with cardiogenic shock complicating myocardial ischemia does not reduce mortality (moderate confidence) and is not associated with a higher risk of complications (very low to low confidence). The results should be interpreted with caution owing to limitations such as imprecision, risk of bias, and clinical heterogeneity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.047 | 0.007 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".