Beyls Christophe, Hanquiez Thomas, Mollet Nicolas, Sarfati Yoni, Zerima Adel, Chafiki Souheil, Besserve Patricia, Dupont Hervé, Diouf Momar, Abou-Arab Osama, Mahjoub Yazine
Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France.
UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, Amiens, France.
Cardiovasc Ther. 2025 May 28;2025:9920490. doi: 10.1155/cdr/9920490. eCollection 2025.
Cardiogenic shock (CS) may lead to a refractory vasoplegic state that requires vasopressin on top of norepinephrine. Vasopressin has been available in France since January 2022. However, data assessing the clinical impact of vasopressin in CS are very scarce. In this study, we aimed to assess the association between vasopressin and 90-day mortality in a cohort of CS. We conducted a retrospective, single-center study at Amiens University Hospital comparing two cohorts of patients experiencing at least Stage C of CS: one historical cohort from 2018 to 2019 without vasopressin and a contemporary cohort from 2022 to 2023 treated with vasopressin. The primary outcome was 90-day mortality. The secondary outcome was the occurrence of serious adverse events (SAEs) during ICU stay. Inverse probability of treatment weighting (IPTW) derived from propensity score was used to reduce imbalances in baseline characteristics. We included 201 patients in the study: 59 in the vasopressin group and 142 in the no vasopressin group. The SOFA score and norepinephrine equivalent were higher in the vasopressin group (13 [10-16] vs. 12 [9-15]; = 0.02 and 0.72 [0.21-1.51] vs. 0.13 [0.07-0.34]; < 0.001, respectively). There was no significant difference between the two groups for the 90-day mortality ( = 31/59 vs. 75/142; = 0.97). Before adjustment, vasopressin was not associated with 90-day mortality (OR = 0.98 [95% CI 0.50-1.78]; = 0.87). After weighting, vasopressin remained not associated with 90-day mortality (OR = 1.10 [95% CI 0.56-2.17]; = 0.77). There was no significant difference for SAEs between the two groups ( = 57/142 [40%] vs. = 23/59 [39%]; = 0.88). Vasopressin was not associated with 30-day mortality and SAEs in patients with CS.
心源性休克（CS）可能导致难治性血管麻痹状态，除去甲肾上腺素外还需要使用血管加压素。自2022年1月起，血管加压素在法国已可供使用。然而，评估血管加压素对CS临床影响的数据非常稀少。在本研究中，我们旨在评估血管加压素与CS队列中90天死亡率之间的关联。我们在亚眠大学医院进行了一项回顾性单中心研究，比较了两组至少经历CS C期的患者：一组是2018年至2019年未使用血管加压素的历史队列，另一组是2022年至2023年接受血管加压素治疗的当代队列。主要结局是90天死亡率。次要结局是重症监护病房（ICU）住院期间严重不良事件（SAE）的发生情况。使用倾向评分得出的治疗权重逆概率（IPTW）来减少基线特征的不平衡。我们纳入了201例患者进行研究：血管加压素组59例，未使用血管加压素组142例。血管加压素组的序贯器官衰竭评估（SOFA）评分和去甲肾上腺素等效剂量更高（分别为13[10 - 16]对12[9 - 15]；P = 0.02和0.72[0.21 - 1.51]对0.13[0.07 - 0.34]；P < 0.001）。两组的90天死亡率无显著差异（分别为31/59对75/142；P = 0.97）。调整前，血管加压素与90天死亡率无关（比值比[OR] = 0.98[95%置信区间（CI）0.50 - 1.78]；P = 0.87）。加权后，血管加压素仍与90天死亡率无关（OR = 1.10[95%CI 0.56 - 2.17]；P = 0.77）。两组之间的SAE无显著差异（分别为57/142[40%]对23/59[39%]；P = 0.88）。血管加压素与CS患者的30天死亡率和SAE无关。
