Epinephrine and short-term survival in cardiogenic shock: an
individual data meta-analysis of 2583 patients

J 2018

Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

LEOPOLD, Valentine, Etienne GAYAT, Romain PIRRACCHIO, Jindřich ŠPINAR, Jiří PAŘENICA et. al.

Basic information

Original name

Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

Authors

LEOPOLD, Valentine (250 France), Etienne GAYAT (250 France), Romain PIRRACCHIO (250 France), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), Tuukka TARVASMAKI (246 Finland), Johan LASSUS (246 Finland), Veli-Pekka HARJOLA (246 Finland), Sebastien CHAMPION (250 France), Faiez ZANNAD (250 France), Serafina VALENTE (380 Italy), Philip URBAN (756 Switzerland), Horng-Ruey CHUA (36 Australia), Rinaldo BELLOMO (36 Australia), Batric POPOVIC (250 France), Dagmar M. OUWENEEL (528 Netherlands), Jose P. S. HENRIQUES (528 Netherlands), Gregor SIMONIS (276 Germany), Bruno LEVY (250 France), Antoine KIMMOUN (250 France), Philippe GAUDARD (250 France), Mir Babar BASIR (840 United States of America), Andrej MARKOTA (705 Slovenia), Christoph ADLER (276 Germany), Hannes REUTER (276 Germany), Alexandre MEBAZAA (250 France, guarantor) and Tahar CHOUIHED (250 France)

Edition

Intensive care medicine, NEW YORK, SPRINGER, 2018, 0342-4642

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 18.967

RIV identification code

RIV/00216224:14110/18:00104160

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s00134-018-5222-9

UT WoS

000435995400012

Keywords in English

Meta-analysis; Cardiogenic shock; Epinephrine; Prognosis

Abstract

V originále

Catecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients. We performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors. The primary outcome was short-term mortality. Fourteen published cohorts and two unpublished data sets were included. We studied 2583 patients. Across all cohorts of patients, the incidence of epinephrine use was 37% (17-76%) and short-term mortality rate was 49% (21-69%). A positive correlation was found between percentages of epinephrine use and short-term mortality in the CS cohort. The risk of death was higher in epinephrine-treated CS patients (OR [CI] = 3.3 [2.8-3.9]) compared to patients treated with other drug regimens. Adjusted mortality risk remained striking in epinephrine-treated patients (n = 1227) (adjusted OR = 4.7 [3.4-6.4]). After propensity score matching, two sets of 338 matched patients were identified and epinephrine use remained associated with a strong detrimental impact on short-term mortality (OR = 4.2 [3.0-6.0]). In this very large cohort, epinephrine use for hemodynamic management of CS patients is associated with a threefold increase of risk of death.

Citovat

LEOPOLD, Valentine, Etienne GAYAT, Romain PIRRACCHIO, Jindřich ŠPINAR, Jiří PAŘENICA, Tuukka TARVASMAKI, Johan LASSUS, Veli-Pekka HARJOLA, Sebastien CHAMPION, Faiez ZANNAD, Serafina VALENTE, Philip URBAN, Horng-Ruey CHUA, Rinaldo BELLOMO, Batric POPOVIC, Dagmar M. OUWENEEL, Jose P. S. HENRIQUES, Gregor SIMONIS, Bruno LEVY, Antoine KIMMOUN, Philippe GAUDARD, Mir Babar BASIR, Andrej MARKOTA, Christoph ADLER, Hannes REUTER, Alexandre MEBAZAA and Tahar CHOUIHED. Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients. Intensive care medicine. NEW YORK: SPRINGER, 2018, vol. 44, No 6, p. 847-856. ISSN 0342-4642. Available from: https://dx.doi.org/10.1007/s00134-018-5222-9.

@article{1454316,
   author = {Leopold, Valentine and Gayat, Etienne and Pirracchio, Romain and Špinar, Jindřich and Pařenica, Jiří and Tarvasmaki, Tuukka and Lassus, Johan and Harjola, VeliandPekka and Champion, Sebastien and Zannad, Faiez and Valente, Serafina and Urban, Philip and Chua, HorngandRuey and Bellomo, Rinaldo and Popovic, Batric and Ouweneel, Dagmar M. and Henriques, Jose P. S. and Simonis, Gregor and Levy, Bruno and Kimmoun, Antoine and Gaudard, Philippe and Basir, Mir Babar and Markota, Andrej and Adler, Christoph and Reuter, Hannes and Mebazaa, Alexandre and Chouihed, Tahar},
   article_location = {NEW YORK},
   article_number = {6},
   doi = {http://dx.doi.org/10.1007/s00134-018-5222-9},
   keywords = {Meta-analysis; Cardiogenic shock; Epinephrine; Prognosis},
   language = {eng},
   issn = {0342-4642},
   journal = {Intensive care medicine},
   title = {Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients},
   volume = {44},
   year = {2018}
}

TY  - JOUR
ID  - 1454316
AU  - Leopold, Valentine - Gayat, Etienne - Pirracchio, Romain - Špinar, Jindřich - Pařenica, Jiří - Tarvasmaki, Tuukka - Lassus, Johan - Harjola, Veli-Pekka - Champion, Sebastien - Zannad, Faiez - Valente, Serafina - Urban, Philip - Chua, Horng-Ruey - Bellomo, Rinaldo - Popovic, Batric - Ouweneel, Dagmar M. - Henriques, Jose P. S. - Simonis, Gregor - Levy, Bruno - Kimmoun, Antoine - Gaudard, Philippe - Basir, Mir Babar - Markota, Andrej - Adler, Christoph - Reuter, Hannes - Mebazaa, Alexandre - Chouihed, Tahar
PY  - 2018
TI  - Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients
JF  - Intensive care medicine
VL  - 44
IS  - 6
SP  - 847-856
EP  - 847-856
PB  - SPRINGER
SN  - 03424642
KW  - Meta-analysis
KW  - Cardiogenic shock
KW  - Epinephrine
KW  - Prognosis
N2  - Catecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients. We performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors. The primary outcome was short-term mortality. Fourteen published cohorts and two unpublished data sets were included. We studied 2583 patients. Across all cohorts of patients, the incidence of epinephrine use was 37% (17-76%) and short-term mortality rate was 49% (21-69%). A positive correlation was found between percentages of epinephrine use and short-term mortality in the CS cohort. The risk of death was higher in epinephrine-treated CS patients (OR [CI] = 3.3 [2.8-3.9]) compared to patients treated with other drug regimens. Adjusted mortality risk remained striking in epinephrine-treated patients (n = 1227) (adjusted OR = 4.7 [3.4-6.4]). After propensity score matching, two sets of 338 matched patients were identified and epinephrine use remained associated with a strong detrimental impact on short-term mortality (OR = 4.2 [3.0-6.0]). In this very large cohort, epinephrine use for hemodynamic management of CS patients is associated with a threefold increase of risk of death.
ER  -

LEOPOLD, Valentine, Etienne GAYAT, Romain PIRRACCHIO, Jindřich ŠPINAR, Jiří PAŘENICA, Tuukka TARVASMAKI, Johan LASSUS, Veli-Pekka HARJOLA, Sebastien CHAMPION, Faiez ZANNAD, Serafina VALENTE, Philip URBAN, Horng-Ruey CHUA, Rinaldo BELLOMO, Batric POPOVIC, Dagmar M. OUWENEEL, Jose P. S. HENRIQUES, Gregor SIMONIS, Bruno LEVY, Antoine KIMMOUN, Philippe GAUDARD, Mir Babar BASIR, Andrej MARKOTA, Christoph ADLER, Hannes REUTER, Alexandre MEBAZAA and Tahar CHOUIHED. Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients. \textit{Intensive care medicine}. NEW YORK: SPRINGER, 2018, vol.~44, No~6, p.~847-856. ISSN~0342-4642. Available from: https://dx.doi.org/10.1007/s00134-018-5222-9.

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