Frontiers in Cardiovascular Medicine (Jan 2023)

One-year outcomes in cardiogenic shock triggered by ventricular arrhythmia: An analysis of the FRENSHOCK multicenter prospective registry

  • Miloud Cherbi,
  • Miloud Cherbi,
  • François Roubille,
  • Nicolas Lamblin,
  • Laurent Bonello,
  • Laurent Bonello,
  • Laurent Bonello,
  • Guillaume Leurent,
  • Bruno Levy,
  • Meyer Elbaz,
  • Meyer Elbaz,
  • Sebastien Champion,
  • Pascal Lim,
  • Pascal Lim,
  • Francis Schneider,
  • Alain Cariou,
  • Hadi Khachab,
  • Jeremy Bourenne,
  • Marie-France Seronde,
  • Guillaume Schurtz,
  • Brahim Harbaoui,
  • Brahim Harbaoui,
  • Gerald Vanzetto,
  • Charlotte Quentin,
  • Xavier Delabranche,
  • Nadia Aissaoui,
  • Nicolas Combaret,
  • Danka Tomasevic,
  • Benjamin Marchandot,
  • Benoit Lattuca,
  • Patrick Henry,
  • Edouard Gerbaud,
  • Edouard Gerbaud,
  • Eric Bonnefoy,
  • Etienne Puymirat,
  • Etienne Puymirat,
  • Philippe Maury,
  • Philippe Maury,
  • Clément Delmas,
  • Clément Delmas,
  • Clément Delmas

DOI
https://doi.org/10.3389/fcvm.2023.1092904
Journal volume & issue
Vol. 10

Abstract

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BackgroundCardiogenic shock (CS) is a life-threatening condition carrying poor prognosis, potentially triggered by ventricular arrhythmia (VA). Whether the occurrence of VA as trigger of CS worsens the prognosis compared to non-VA triggers remains unclear. The aim of this study was to evaluate 1-year outcomes [mortality, heart transplantation, ventricular assist devices (VAD)] between VA-triggered and non-VA-triggered CS.MethodsFRENSHOCK is a prospective multicenter registry including 772 CS patients from 49 centers. One to three triggers can be identified in the registry (ischemic, mechanical complications, ventricular/supraventricular arrhythmia, bradycardia, iatrogenesis, infection, non-compliance). Baseline characteristics, management and 1-year outcomes were analyzed according to the VA-trigger in the CS population.ResultsWithin 769 CS patients included, 94 were VA-triggered (12.2%) and were compared to others. At 1 year, although there was no mortality difference [42.6 vs. 45.3%, HR 0.94 (0.67–1.30), p = 0.7], VA-triggered CS resulted in more heart transplantations and VAD (17 vs. 9%, p = 0.02). Into VA-triggered CS group, though there was no 1-year mortality difference between ischemic and non-ischemic cardiomyopathies [42.5 vs. 42.6%, HR 0.97 (0.52–1.81), p = 0.92], non-ischemic cardiomyopathy led to more heart transplantations and VAD (25.9 vs. 5%, p = 0.02).ConclusionVA-triggered CS did not show higher mortality compared to other triggers but resulted in more heart transplantation and VAD at 1 year, especially in non-ischemic cardiomyopathy, suggesting the need for earlier evaluation by advanced heart failure specialized team for a possible indication of mechanical circulatory support or heart transplantation.Clinical trial registrationhttps://clinicaltrials.gov, identifier NCT02703038.

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