Lancet
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Randomized Controlled Trial Multicenter Study
Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial.
In current international guidelines the recommendation for intra-aortic balloon pump (IABP) use has been downgraded in cardiogenic shock complicating acute myocardial infarction on the basis of registry data. In the largest randomised trial (IABP-SHOCK II), IABP support did not reduce 30 day mortality compared with control. However, previous trials in cardiogenic shock showed a mortality benefit only at extended follow-up. The present analysis therefore reports 6 and 12 month results. ⋯ German Research Foundation; German Heart Research Foundation; German Cardiac Society; Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte; University of Leipzig--Heart Centre; Maquet Cardiopulmonary; Teleflex Medical.
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Global health, population growth, economic development, environmental degradation, and climate change are the main challenges we face in the 21st century. However, because the academics, non-governmental organisations, and policy makers in these specialties work within separate communities, our understanding of the associations between them is restricted. ⋯ The conference provided the impetus for this Review, which describes, in historical context, key events and fundamental intercommunity debates from the perspectives of population, development, and climate change communities. We consider the interconnections between population, development, and climate change and their effects on health, including new analysis of longstanding debates, and identify opportunities for effective collaboration on shared goals.