Key result
Non-ischaemic cardiogenic shock carries ~46% one-year mortality, strongly predicted by CKD and acute RRT.
Why the study?
Non-ischaemic cardiogenic shock (NICS) is predominant in routine practice but underrepresented in past studies mainly focused on ischaemic cardiogenic shock.
Observational (n=492)
Yes
Non-ischaemic cardiogenic shock accounts for nearly two-thirds of cardiogenic shock cases and is associated with high short- and long-term mortality, driven by factors such as age, chronic kidney disease, and norepinephrine use.
High mortality with key predictors in non-ischaemic cardiogenic shock; hypothesis-generating and requires prospective validation before guiding care.
AIMS: Although predominant in routine practice, non-ischaemic cardiogenic shock (NICS) remains underrepresented in past studies, mainly focused on ischaemic cardiogenic shock (CS). This study aims to describe the current NICS picture and define its independent correlates of short- and long-term outcomes. METHODS AND RESULTS: FRENSHOCK is a prospective registry including 772 CS patients from 49 centers. One-year mortality was the primary outcome. One-month mortality and the composite of 1-year mortality, heart transplantation (HTx), or ventricular assistance device (VAD) were secondary outcomes. Within 772 patients included, 492 (63.7%) were NICS. One-month and 1-year mortality rates were 25.6% and 45.7%, with a combined endpoint of 1-year mortality, HTx, or VAD of 53.9%. Multivariate analysis showed five independent factors for 1-year mortality: age (per year: aHR 1.03 [1.01-1.05], P < 0.01), chronic kidney disease (CKD) (aHR 1.87 [1.25-2.80], P < 0.01), norepinephrine use (aHR 1.52 [1.02-2.26], P = 0.04), active cancer (aHR 1.91 [1.07-3.42], P = 0.03) and acute renal replacement therapy (aHR 1.57 [1.01-2.46], P = 0.049). Age, CKD and norepinephrine were also predictive of 1-month mortality and 1-year mortality and/or HTx and/or VAD. Additionally, 1-month mortality was associated with septic triggers, and 1-year mortality and/or HTx and/or VAD with acute mechanical circulatory support, NYHA stage ≥ 3 and fluid administration. CONCLUSIONS: In this large study, NICS accounted for almost two-thirds of all CS cases, with substantial rates of short- and long-term mortality. Future studies should evaluate interventions to improve early stratification and management. NCT02703038.
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Cherbi et al. (2025) conducted an observational in Non-ischaemic cardiogenic shock (n=492). Non-ischaemic cardiogenic shock was evaluated on One-year mortality. In patients with non-ischaemic cardiogenic shock, 1-year mortality was 45.7%, independently predicted by age, chronic kidney disease (aHR 1.87), norepinephrine use, active cancer, and acute RRT.
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