Article Dans Une Revue Journal of the American Heart Association Année : 2024

Optimal Heart Failure Medical Therapy and Mortality in Survivors of Cardiogenic Shock: Insights From the FRENSHOCK Registry

1 MCVT - Médecine Cardiovasculaire Translationnelle
2 Nouvel Hôpital Civil de Strasbourg
3 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
4 UPS/Inserm U1297 - I2MC - Institut des Maladies Métaboliques et Casdiovasculaires
5 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
6 HUS - Les Hôpitaux Universitaires de Strasbourg
7 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
8 UNIROUEN UFR Santé - UNIROUEN - UFR Santé
9 Centre Hospitalier Universitaire [Rennes]
10 LTSI - Laboratoire Traitement du Signal et de l'Image
11 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
12 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
13 Hôpital privé de Parly 2 - Ramsay Santé [Le Chesnay-Rocquencourt]
14 Hôpital Henri Mondor
15 IMRB - Institut Mondor de Recherche Biomédicale
16 BB - Biomatériaux et Bioingénierie
17 CHIAP - Centre Hospitalier d'Aix en Provence [Aix-en-Provence]
18 Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire [Strasbourg]
19 BSC - Biotechnologie et signalisation cellulaire
20 Service d'anesthésie et de réanimation [Hôpital de la Timone - APHM]
21 Service de cardiologie [CHRU de Besançon]
22 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
23 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
24 CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
25 Hôpital de la Croix-Rousse [CHU - HCL]
26 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
27 Imagerie Ultrasonore
28 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
29 CHU Tenon [AP-HP]
30 CHU Clermont-Ferrand
31 UCA - Université Clermont Auvergne
32 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
33 ORPHY (EA 4324) - Optimisation des régulations physiologiques
34 Service de cardiologie [Vannes]
35 CHU Amiens-Picardie
36 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517
37 NanoRegMed - Nanomédecine Régénérative
38 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
39 UM - Université de Montpellier
40 CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux]
41 Hôpital Haut-Lévêque [CHU Bordeaux]
42 Ecole de Santé Militaire de Lyon-Bron
43 HEGP - Hôpital Européen Georges Pompidou [APHP]
44 Hôpital Nord [CHU - APHM]
45 AMU - Aix Marseille Université
Vincent Labbe
  • Fonction : Auteur
Emmanuelle Filippi
Eric Bonnefoy

Résumé

Background The effects of pharmacological therapy on cardiogenic shock (CS) survivors have not been extensively studied. Thus, this study investigated the association between guideline‐directed heart failure (HF) medical therapy (GDMT) and one‐year survival rate in patients who are post‐CS. Methods and Results FRENSHOCK (French Observatory on the Management of Cardiogenic Shock in 2016) registry was a prospective multicenter observational survey, conducted in metropolitan French intensive care units and intensive cardiac care units. Of 772 patients, 535 patients were enrolled in the present analysis following the exclusion of 217 in‐hospital deaths and 20 patients with missing medical records. Patients with triple GDMT (beta‐blockers, renin‐angiotensin system inhibitors, and mineralocorticoid receptor antagonists) at discharge (n=112) were likely to have lower left ventricular ejection fraction on admission and at discharge compared with those without triple GDMT (n=423) (22% versus 28%, P <0.001 and 29% versus 37%, P <0.001, respectively). In the overall cohort, the one‐year mortality rate was 23%. Triple GDMT prescription was significantly associated with a lower one‐year all‐cause mortality compared with non‐triple GDMT (adjusted hazard ratio 0.44 [95% CI, 0.19–0.80]; P =0.007). Similarly, 2:1 propensity score matching and inverse probability treatment weighting based on the propensity score demonstrated a lower incidence of one‐year mortality in the triple GDMT group. As the number of HF drugs increased, a stepwise decrease in mortality was observed (log rank; P <0.001). Conclusions In survivors of CS, the one‐year mortality rate was significantly lower in those with triple GDMT. Therefore, this study suggests that intensive HF therapy should be considered in patients following CS.
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hal-04902584 , version 1 (21-01-2025)

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Kensuke Matsushita, Clément Delmas, Benjamin Marchandot, François Roubille, Nicolas Lamblin, et al.. Optimal Heart Failure Medical Therapy and Mortality in Survivors of Cardiogenic Shock: Insights From the FRENSHOCK Registry. Journal of the American Heart Association, 2024, 13 (5), ⟨10.1161/JAHA.123.030975⟩. ⟨hal-04902584⟩
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