***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: Seven eligible studies were identified from a total of 2314 references. One new study with 600 patients was added to the original review. Four trials compared IABP to standard treatment and three to other percutaneous left assist devices (LVAD). Data from a total of 790 patients with acute myocardial infarction and cardiogenic shock were included in the updated meta-analysis: 406 patients were treated with IABP and 384 patients served as controls; 339 patients were treated without assisting devices and 45 patients with other LVAD. The HR for all-cause 30-day mortality of 0.95 (95% CI 0.76 to 1.19) provided no evidence for a survival benefit. Different non-fatal cardiovascular events were reported in five trials. During hospitalisation, 11 and 4 out of 364 patients from the intervention groups suffered from reinfarction or stroke, respectively. Altogether 5 out of 363 patients from the control group suffered from reinfarction or stroke. Reocclusion was treated with subsequent re-revascularization in 6 out of 352 patients from the intervention group and 13 out of 353 patients of the control group. The high incidence of complications such as moderate and severe bleeding or infection in the control groups has to be attributed to interventions with other LVAD. Possible reasons for bias were more frequent in small studies with high cross-over rates, early stopping and the inclusion of patients with IABP at randomisation. Available evidence suggests that IABP may have a beneficial effect on some haemodynamic parameters. However, this did not result in survival benefits so there is no convincing randomised data to support the use of IABP in infarct-related cardiogenic shock.
Output:

In contrast to the previous version of this review, this update now includes data from one large and six small randomised controlled trials. It allows more definitive conclusions about the potential beneficial or harmful clinical effects of IABP support beyond its immediate haemodynamic effects. Complications such as moderate and severe bleeding were more frequently observed in patients treated with more invasive devices than IABP. Small randomised trials suffered from inadequate power to address deaths and harmful effects of IABP and were biased by frequent cross-over to the more aggressive strategy, early stopping of the trial, or the inclusion of patients with IABP at randomisation. It is most noteworthy that a recently conducted and published large randomised trial showed no evidence for survival benefits of IABP support in patients with infarct-related cardiogenic shock treated by percutaneous coronary intervention (PCI). On the basis of these data, IABP support is no longer strongly recommended by the European Society of Cardiology (ESC) guidelines for treatment of patients with infarct-related cardiogenic shock. Rather, IABP use is based on the personal experience and decision of the physician and the particular circumstances of individual patients.