Cardiogenic shock and infection: A lethal combination.

Area of Science:

• Cardiology
• Intensive Care Medicine
• Infectious Diseases

Background:

• Cardiogenic shock and sepsis are critical hemodynamic conditions with high mortality.
• Combined sepsis and cardiogenic shock have limited research despite clinical significance.

Purpose of the Study:

• To investigate the outcomes of patients experiencing cardiogenic shock triggered by sepsis.
• To compare mortality rates and treatment strategies in sepsis-triggered cardiogenic shock versus other causes.

Main Methods:

• Prospective registry (FRENSHOCK) of 772 patients with cardiogenic shock across 49 centers.
• Primary endpoint: 1-month all-cause mortality.
• Secondary endpoints: 1-year mortality, heart transplantation, and ventricular assistance device implantation.

Main Results:

• Sepsis triggered cardiogenic shock in 11.9% of patients, associated with increased renal/hepatic injuries and lower mean arterial pressure.
• Patients with sepsis-triggered cardiogenic shock required more vasopressors and renal replacement therapy.
• 1-month mortality was 41.3% vs. 24.0% and 1-year mortality was 62.0% vs. 42.9% in the sepsis group compared to non-sepsis group, respectively.

Conclusions:

• Sepsis-triggered cardiogenic shock is a high-risk scenario associated with significantly higher short- and long-term mortality.
• Outcomes were worse regardless of pre-existing cardiomyopathy or co-occurring shock triggers.