ArticleTrials2022
Low-dose corticosteroid therapy for cardiogenic shock in adults (COCCA): study protocol for a randomized controlled trial.
Article in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03773822 (Low Dose of Hydrocortisone and Fludrocortisone in Adult Cardiogenic Shock. A Multicenter, Prospective, Double-blind, Randomized, Placebo-controlled Study), which is not on this map. Cited by 13 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Low Dose of Hydrocortisone and Fludrocortisone in Adult Cardiogenic Shock. A Multicenter, Prospective, Double-blind, Randomized, Placebo-controlled Study
Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Early Corticosteroid use and Clinical Outcomes in Patients with Mixed and Cardiogenic Shock.Journal of intensive care medicine · 2026Article
- Evolving Evidence-Driven Strategies in Cardiogenic Shock Management.JACC. Advances · 2026Review
- A Recovery-Focused Framework for the Management of Cardiogenic Shock.Circulation. Heart failure · 2026Review
- The Prognostic Role of Cortisol and Glucose Dynamics in Cardiogenic Shock-Insights from a Prospective Observational Cohort.Journal of cardiovascular translational research · 2025Observational
- Inflammatory Indices in Patients with Myocardial Infarction Complicated by Cardiogenic Shock, and Their Interconnections with SCAI Stages and Patients' Survival: A Retrospective Study.Journal of clinical medicine · 2025Article
- Corticosteroids in Cardiogenic Shock: A Retrospective Analysis of the Medical Information Mart for Intensive Care-IV Database.Critical care explorations · 2025Article
- Cardiometabolic shock: understanding the final turns of the downward spiral.Frontiers in cardiovascular medicine · 2025Review
- The Role of Inflammation in the Pathogenesis of Cardiogenic Shock Secondary to Acute Myocardial Infarction: A Narrative Review.Biomedicines · 2024Review
- Pathophysiologic Vasodilation in Cardiogenic Shock and Its Impact on Mortality.Circulation. Heart failure · 2024Article
- The admission level of CRP during cardiogenic shock is a strong independent risk marker of mortality.Scientific reports · 2024Article
- Association between short-term systemic use of glucocorticoids and prognosis of cardiogenic shock: a retrospective analysis.BMC anesthesiology · 2023Article
- The medical treatment of cardiogenic shock.Journal of intensive medicine · 2023Review
- Cardiac and vascular effects of low-dose steroids during the early phase of septic shock: An echocardiographic study.Frontiers in cardiovascular medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardiogenic shock (CS) is a life-threatening condition characterized by circulatory insufficiency caused by an acute dysfunction of the heart pump. The pathophysiological approach to CS has recently been enriched by the tissue consequences of low flow, including inflammation, endothelial dysfunction, and alteration of the hypothalamic-pituitary-adrenal axis. The aim of the present trial is to evaluate the impact of early low-dose corticosteroid therapy on shock reversal in adults with CS. METHOD/
designThis is a multicentered randomized, double-blind, placebo-controlled trial with two parallel arms in adult patients with CS recruited from medical, cardiac, and polyvalent intensive care units (ICU) in France. Patients will be randomly allocated into the treatment or control group (1:1 ratio), and we will recruit 380 patients (190 per group). For the treatment group, hydrocortisone (50 mg intravenous bolus every 6 h) and fludrocortisone (50 μg once a day enterally) will be administered for 7 days or until discharge from the ICU. The primary endpoint is catecholamine-free days at day 7. Secondary endpoints include morbidity and all-cause mortality at 28 and 90 days post-randomization. Pre-defined subgroups analyses are planned, including: postcardiotomy, myocardial infarction, etomidate use, vasopressor use, and adrenal profiles according the short corticotropin stimulation test. Each patient will be followed for 90 days. All analyses will be conducted on an intention-to-treat basis. DISCUSSION: This trial will provide valuable evidence about the effectiveness of low dose of corticosteroid therapy for CS. If effective, this therapy might improve outcome and become a therapeutic adjunct for patients with CS.
trial registrationClinicalTrials.gov , NCT03773822 . Registered on 12 December 2018.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.