The Effectiveness of Inodilators in Reducing Short Term
Mortality among Patient with Severe Cardiogenic Shock: A
Propensity-Based Analysis

J 2013

The Effectiveness of Inodilators in Reducing Short Term Mortality among Patient with Severe Cardiogenic Shock: A Propensity-Based Analysis

PIRRACCHIO, Romain; Jiří PAŘENICA; Matthieu Resche RIGON; Sylvie CHEVRET; Jindřich ŠPINAR et al.

Základní údaje

Originální název

The Effectiveness of Inodilators in Reducing Short Term Mortality among Patient with Severe Cardiogenic Shock: A Propensity-Based Analysis

Autoři

PIRRACCHIO, Romain; Jiří PAŘENICA; Matthieu Resche RIGON; Sylvie CHEVRET; Jindřich ŠPINAR; Jiří JARKOVSKÝ ; Faiez ZANNAD; Francois ALLA a Alexandre MEBAZAA

Vydání

Plos One, SAN FRANCISCO, PUBLIC LIBRARY SCIENCE, 2013, 1932-6203

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 3.534

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/13:00069742

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1371/journal.pone.0071659

UT WoS

000323378000063

Klíčová slova anglicky

ACUTE HEART-FAILURE; MICROCIRCULATORY BLOOD-FLOW; VENTRICULAR-FUNCTION; CONTROLLED TRIAL; NOREPINEPHRINE; DOBUTAMINE; NITROGLYCERIN; EPINEPHRINE; GUIDELINES; MANAGEMENT

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 15. 10. 2013 16:46, Soňa Böhmová

Anotace

V originále

Background:The best catecholamine regimen for cardiogenic shock has been poorly evaluated. When a vasopressor is required to treat patients with the most severe form of cardiogenic shock, whether inodilators should be added or whether inopressors can be used alone has not been established. The purpose of this study was to compare the impact of these two strategies on short-term mortality in patients with severe cardiogenic shocks.Methods and Results:Three observational cohorts of patients with decompensated heart failure were pooled to comprise a total of 1,272 patients with cardiogenic shocks. Of these 1,272 patients, 988 were considered to be severe because they required a vasopressor during the first 24 hours. We developed a propensity-score (PS) model to predict the individual probability of receiving one of the two regimens (inopressors alone or a combination) conditionally on baseline-measured covariates. The benefit of the treatment regimen on the mortality rate was estimated by fitting a weighted Cox regression model. A total of 643 patients (65.1%) died within the first 30 days (inopressors alone: 293 (72.0%); inopressors and inodilators: 350 (60.0%)). After PS weighting, we observed that the use of an inopressor plus an inodilator was associated with an improved short-term mortality (HR: 0.66 [0.55-0.80]) compared to inopressors alone.Conclusions:In the most severe forms of cardiogenic shock where a vasopressor is immediately required, adding an inodilator may improve short-term mortality. This result should be confirmed in a randomized, controlled trial.

Citovat

PIRRACCHIO, Romain; Jiří PAŘENICA; Matthieu Resche RIGON; Sylvie CHEVRET; Jindřich ŠPINAR; Jiří JARKOVSKÝ; Faiez ZANNAD; Francois ALLA a Alexandre MEBAZAA. The Effectiveness of Inodilators in Reducing Short Term Mortality among Patient with Severe Cardiogenic Shock: A Propensity-Based Analysis. Plos One. SAN FRANCISCO: PUBLIC LIBRARY SCIENCE, 2013, roč. 8, č. 8, s. e71659, 10 s. ISSN 1932-6203. Dostupné z: https://doi.org/10.1371/journal.pone.0071659.

@article{1126259,
   author = {Pirracchio, Romain and Pařenica, Jiří and Rigon, Matthieu Resche and Chevret, Sylvie and Špinar, Jindřich and Jarkovský, Jiří and Zannad, Faiez and Alla, Francois and Mebazaa, Alexandre},
   article_location = {SAN FRANCISCO},
   article_number = {8},
   doi = {https://doi.org/10.1371/journal.pone.0071659},
   keywords = {ACUTE HEART-FAILURE; MICROCIRCULATORY BLOOD-FLOW; VENTRICULAR-FUNCTION; CONTROLLED TRIAL; NOREPINEPHRINE; DOBUTAMINE; NITROGLYCERIN; EPINEPHRINE; GUIDELINES; MANAGEMENT},
   language = {eng},
   issn = {1932-6203},
   journal = {Plos One},
   title = {The Effectiveness of Inodilators in Reducing Short Term Mortality among Patient with Severe Cardiogenic Shock: A Propensity-Based Analysis},
   volume = {8},
   year = {2013}
}

TY  - JOUR
ID  - 1126259
AU  - Pirracchio, Romain - Pařenica, Jiří - Rigon, Matthieu Resche - Chevret, Sylvie - Špinar, Jindřich - Jarkovský, Jiří - Zannad, Faiez - Alla, Francois - Mebazaa, Alexandre
PY  - 2013
TI  - The Effectiveness of Inodilators in Reducing Short Term Mortality among Patient with Severe Cardiogenic Shock: A Propensity-Based Analysis
JF  - Plos One
VL  - 8
IS  - 8
SP  - e71659
EP  - e71659
PB  - PUBLIC LIBRARY SCIENCE
SN  - 19326203
KW  - ACUTE HEART-FAILURE
KW  - MICROCIRCULATORY BLOOD-FLOW
KW  - VENTRICULAR-FUNCTION
KW  - CONTROLLED TRIAL
KW  - NOREPINEPHRINE
KW  - DOBUTAMINE
KW  - NITROGLYCERIN
KW  - EPINEPHRINE
KW  - GUIDELINES
KW  - MANAGEMENT
N2  - Background:The best catecholamine regimen for cardiogenic shock has been poorly evaluated. When a vasopressor is required to treat patients with the most severe form of cardiogenic shock, whether inodilators should be added or whether inopressors can be used alone has not been established. The purpose of this study was to compare the impact of these two strategies on short-term mortality in patients with severe cardiogenic shocks.Methods and Results:Three observational cohorts of patients with decompensated heart failure were pooled to comprise a total of 1,272 patients with cardiogenic shocks. Of these 1,272 patients, 988 were considered to be severe because they required a vasopressor during the first 24 hours. We developed a propensity-score (PS) model to predict the individual probability of receiving one of the two regimens (inopressors alone or a combination) conditionally on baseline-measured covariates. The benefit of the treatment regimen on the mortality rate was estimated by fitting a weighted Cox regression model. A total of 643 patients (65.1%) died within the first 30 days (inopressors alone: 293 (72.0%); inopressors and inodilators: 350 (60.0%)). After PS weighting, we observed that the use of an inopressor plus an inodilator was associated with an improved short-term mortality (HR: 0.66 [0.55-0.80]) compared to inopressors alone.Conclusions:In the most severe forms of cardiogenic shock where a vasopressor is immediately required, adding an inodilator may improve short-term mortality. This result should be confirmed in a randomized, controlled trial.
ER  -

PIRRACCHIO, Romain; Jiří PAŘENICA; Matthieu Resche RIGON; Sylvie CHEVRET; Jindřich ŠPINAR; Jiří JARKOVSKÝ; Faiez ZANNAD; Francois ALLA a Alexandre MEBAZAA. The Effectiveness of Inodilators in Reducing Short Term Mortality among Patient with Severe Cardiogenic Shock: A Propensity-Based Analysis. \textit{Plos One}. SAN FRANCISCO: PUBLIC LIBRARY SCIENCE, 2013, roč.~8, č.~8, s.~e71659, 10 s. ISSN~1932-6203. Dostupné z: https://doi.org/10.1371/journal.pone.0071659.

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