PDF(Pubmed)
Abstract：
UNASSIGNED: Pharmacological support has become the mainstay therapy in patients with cardiogenic shock (CS). Unfortunately, the clinical benefits of such potent drugs remain unclear, therefore, the present study aims to elucidate the safety and efficacy of vasoactive agents in CS patients.
UNASSIGNED: Medical Information Mart for Intensive Care (MIMIC) IV databases were used for this retrospective study. The primary outcome of this study was 30-day all-cause mortality. The subgroup analysis of was the relationship between the combined use of vasopressors and inotropes and 30-day all-cause mortality.
UNASSIGNED: A total of 2,216 patients diagnosed with CS were enrolled in this study. The non-survivors group was more likely to be older, presented with chronic kidney disease, have a lower systolic blood pressure, lower heart rate, and higher respiratory rate (all p < 0.05). In the multivariate Cox regression analysis, only dopamine [HR (95%CI): 1.219 (1.003-1.482)], norepinephrine [HR (95%CI): 2.528 (1.829-3.493)], and milrinone [HR (95%CI): 0.664 (0.512-0.861)] remained an independent predictor for 30-day all-cause mortality. Furthermore, a subgroup analysis was performed and found that no statistically significant difference between no vasopressor/inotrope use and 1 vasopressor/inotrope use (p = 0.107). Meanwhile, a substantial deterioration of cumulative survival was observed when a combination of 2 or more vasopressors/inotropes was used in CS patients in comparison with no vasopressor/inotrope or only 1 vasopressor/inotrope use (all p < 0.05).
UNASSIGNED: Using vasopressors/inotropes agents was associated with a higher risk of 30-day all-cause mortality in CS patients. In addition, only milrinone was associated with a better prognosis among the available vasoactive agents.
UNASSIGNED: Medical Information Mart for Intensive Care (MIMIC) IV databases were used for this retrospective study. The primary outcome of this study was 30-day all-cause mortality. The subgroup analysis of was the relationship between the combined use of vasopressors and inotropes and 30-day all-cause mortality.
UNASSIGNED: A total of 2,216 patients diagnosed with CS were enrolled in this study. The non-survivors group was more likely to be older, presented with chronic kidney disease, have a lower systolic blood pressure, lower heart rate, and higher respiratory rate (all p < 0.05). In the multivariate Cox regression analysis, only dopamine [HR (95%CI): 1.219 (1.003-1.482)], norepinephrine [HR (95%CI): 2.528 (1.829-3.493)], and milrinone [HR (95%CI): 0.664 (0.512-0.861)] remained an independent predictor for 30-day all-cause mortality. Furthermore, a subgroup analysis was performed and found that no statistically significant difference between no vasopressor/inotrope use and 1 vasopressor/inotrope use (p = 0.107). Meanwhile, a substantial deterioration of cumulative survival was observed when a combination of 2 or more vasopressors/inotropes was used in CS patients in comparison with no vasopressor/inotrope or only 1 vasopressor/inotrope use (all p < 0.05).
UNASSIGNED: Using vasopressors/inotropes agents was associated with a higher risk of 30-day all-cause mortality in CS patients. In addition, only milrinone was associated with a better prognosis among the available vasoactive agents.
摘要：
■药物支持已成为心源性休克（CS）患者的主要治疗方法。不幸的是,这种强效药物的临床益处尚不清楚，因此,本研究旨在阐明血管活性药物在CS患者中的安全性和有效性.
■重症监护医学信息集市（MIMIC）IV数据库用于本回顾性研究。这项研究的主要结果是30天全因死亡率。的亚组分析是血管加压药和肌力强化剂的联合使用与30天全因死亡率之间的关系。
■本研究共纳入2,216例诊断为CS的患者。非幸存者组年龄更大，患有慢性肾病，收缩压较低，降低心率,和更高的呼吸频率（所有p<0.05）。在多元Cox回归分析中，仅多巴胺[HR（95CI）：1.219（1.003-1.482）]，去甲肾上腺素[HR（95CI）：2.528（1.829-3.493）]，米力农[HR(95CI):0.664(0.512-0.861)]仍然是30日全因死亡率的独立预测因子.此外，我们进行了一项亚组分析,发现没有使用血管加压药/抗张剂和使用1次血管加压药/抗张剂之间无统计学差异(p=0.107).同时,当CS患者使用2种或更多种血管加压药/肌力强化剂的组合时,与不使用血管加压药/肌力强化剂或仅使用1种血管加压药/肌力强化剂相比,观察到累积生存率显著下降(均p<0.05).
■在CS患者中，使用血管加压药/促效药与30天全因死亡的风险更高相关。此外,在现有的血管活性药物中,只有米力农与较好的预后相关.
■重症监护医学信息集市（MIMIC）IV数据库用于本回顾性研究。这项研究的主要结果是30天全因死亡率。的亚组分析是血管加压药和肌力强化剂的联合使用与30天全因死亡率之间的关系。
■本研究共纳入2,216例诊断为CS的患者。非幸存者组年龄更大，患有慢性肾病，收缩压较低，降低心率,和更高的呼吸频率（所有p<0.05）。在多元Cox回归分析中，仅多巴胺[HR（95CI）：1.219（1.003-1.482）]，去甲肾上腺素[HR（95CI）：2.528（1.829-3.493）]，米力农[HR(95CI):0.664(0.512-0.861)]仍然是30日全因死亡率的独立预测因子.此外，我们进行了一项亚组分析,发现没有使用血管加压药/抗张剂和使用1次血管加压药/抗张剂之间无统计学差异(p=0.107).同时,当CS患者使用2种或更多种血管加压药/肌力强化剂的组合时,与不使用血管加压药/肌力强化剂或仅使用1种血管加压药/肌力强化剂相比,观察到累积生存率显著下降(均p<0.05).
■在CS患者中，使用血管加压药/促效药与30天全因死亡的风险更高相关。此外,在现有的血管活性药物中,只有米力农与较好的预后相关.
