AUTHOR=Cherbi Miloud , Roubille François , Lamblin Nicolas , Bonello Laurent , Leurent Guillaume , Levy Bruno , Elbaz Meyer , Champion Sebastien , Lim Pascal , Schneider Francis , Cariou Alain , Khachab Hadi , Bourenne Jeremy , Seronde Marie-France , Schurtz Guillaume , Harbaoui Brahim , Vanzetto Gerald , Quentin Charlotte , Delabranche Xavier , Aissaoui Nadia , Combaret Nicolas , Tomasevic Danka , Marchandot Benjamin , Lattuca Benoit , Henry Patrick , Gerbaud Edouard , Bonnefoy Eric , Puymirat Etienne , Maury Philippe , Delmas Clément 

TITLE=One-year outcomes in cardiogenic shock triggered by ventricular arrhythmia: An analysis of the FRENSHOCK multicenter prospective registry

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1092904

DOI=10.3389/fcvm.2023.1092904

ISSN=2297-055X

ABSTRACT=Background: Cardiogenic shock (CS) is a life-threatening condition carrying poor prognosis, potentially triggered by ventricular arrhythmia (VA). Whether the occurrence of VA as trigger of CS worsens the prognosis compared to non-VA triggers remains unclear. The aim of this study was to evaluate one-year outcomes (mortality, heart transplantation, ventricular assist devices (VAD)) between VA-triggered and non-VA-triggered CS.
Methods: FRENSHOCK is a prospective multicenter registry including 772 CS patients from 49 centers. One to three triggers can be identified in the registry (ischemic, mechanical complications, ventricular/supraventricular arrhythmia, bradycardia, iatrogenesis, infection, non-compliance). Baseline characteristics, management and 1-year outcomes were analyzed according to the VA-trigger in the CS population.
Results: Within 769 CS patients included, 94 were VA-triggered (12.2%) and were compared to others. At one year, although there was no mortality difference (42.6% vs 45.3%, HR 0.94 [0.67 - 1.30], p = 0.7), VA-triggered CS resulted in more heart transplantations and VAD (17% vs 9%, p = 0.02). Into VA-triggered CS group, though there was no one-year mortality difference between ischemic and non-ischemic cardiomyopathies (42.5% vs 42.6%, HR 0.97 [0.52 – 1.81], p = 0.92), non-ischemic cardiomyopathy led to more heart transplantations and VAD (25.9% vs 5%, p = 0.02).
Conclusion: VA-triggered CS did not show higher mortality compared to other triggers but resulted in more heart transplantation and VAD at one year, especially in non-ischemic cardiomyopathy, suggesting the need for earlier evaluation for mechanical circulatory support or heart transplantation in that population.
NCT02703038