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Adrenal Insufficiency in patients with cardiogenic shock: A meta-analysis

Nso Nso1, Mahmoud Nassar1, Bahaaeldin Baraka2

  • 1Internal Medicine Department, Icahn School of Medicine at Mount Sinai / NYC Health+Hospitals / Queens, New York, NY, USA.

Diabetes & Metabolic Syndrome
|October 10, 2021
PubMed

Insights

Adrenal Insufficiency (AI) affects about 32% of patients with cardiogenic shock (CS). This meta-analysis highlights a moderate prevalence of AI in CS patients, impacting clinical outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Critical Care Medicine

Background:

  • Adrenal Insufficiency (AI) is infrequently diagnosed in patients experiencing cardiogenic shock (CS).
  • Understanding the prevalence and impact of AI in CS is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence of Adrenal Insufficiency (AI) in patients with cardiogenic shock (CS).
  • To assess the clinical outcomes associated with AI in CS patients.

Main Methods:

  • A systematic literature search was conducted across major scientific databases (PubMed/Medline, Science Direct, World Wide Science.org, Pro-Quest).
  • Included studies focused on patients with CS, post-cardiac-arrest shock, out-of-hospital cardiac arrest, and CS post-myocardial infarction.
  • Data analysis utilized RStudio, and AI diagnosis was confirmed via corticotropin stimulation tests.

Main Results:

  • Five observational cohort studies were included in the meta-analysis, reporting low-to-fair quality.
  • The pooled prevalence of AI in CS patients was estimated at 32% (95% CI: 21%-45%), with significant heterogeneity observed (I² = 81%, P = 0.001).
  • The overall prevalence range for AI in CS patients was determined to be between 11% and 51%.

Conclusions:

  • This meta-analysis indicates a moderate prevalence of Adrenal Insufficiency (AI) among patients with cardiogenic shock (CS).
  • Further research may be warranted to fully elucidate the clinical implications and management strategies for AI in CS.
Abstract

Keywords:
Adrenal InsufficiencyCardiac arrestCardiogenic shockCardiovascularEndocrineMeta-analysis

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