ArticleESC heart failure2022
Norepinephrine use in cardiogenic shock patients is associated with increased 30 day mortality.
Article in ESC heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Comparative Efficacy of Noradrenaline vs. Other Vasopressors on Outcomes in Patients With Cardiogenic Shock - A Systematic Review and Meta-Analysis.Circulation reports · 2025Article
- In a quest for better outcome prediction in cardiogenic shock.ESC heart failure · 2025Article
- Comparison of machine learning and nomogram to predict 30-day in-hospital mortality in patients with acute myocardial infarction combined with cardiogenic shock: a retrospective study based on the eICU-CRD and MIMIC-IV databases.BMC cardiovascular disorders · 2025Article
- Corticosteroids in Cardiogenic Shock: A Retrospective Analysis of the Medical Information Mart for Intensive Care-IV Database.Critical care explorations · 2025Article
- Safety and efficacy of up to 60 h of iv istaroxime in pre-cardiogenic shock patients: Design of the SEISMiC trial.ESC heart failure · 2025Article
- Value of APACHE II, SOFA and CardShock scoring as predictive tools for cardiogenic shock: A single-centre pilot study.ESC heart failure · 2024Observational
- Management of cardiogenic shock: state-of-the-art.Intensive care medicine · 2024Review
- Review
- Clinical Effect of Norepinephrine Combined with Esmolol Treatment in Patients with Septic Shock and Its Impact on Prognosis.International journal of general medicine · 2024Article
- Vasopressors and inotropes in cardiogenic shock patients: an analysis of the MIMIC-IV database.Frontiers in cardiovascular medicine · 2023Article
- Norepinephrine use in cardiogenic shock patients is associated with increased 30 day mortality.ESC heart failure · 2022Article
- Explainable time-series deep learning models for the prediction of mortality, prolonged length of stay and 30-day readmission in intensive care patients.Frontiers in medicine · 2022Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsNorepinephrine is recommended as a first-line vasopressor agent in the haemodynamic stabilization of cardiogenic shock. The survival benefit of norepinephrine therapy has not been demonstrated in clinical practice, however. This study aimed to explore the relationship between norepinephrine use and outcomes in cardiogenic shock patients in real-world conditions. METHODS AND
resultsWe conducted a retrospective cohort study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. Cardiogenic shock patients were enrolled and categorized into a norepinephrine group or a non-norepinephrine group. Propensity score matching (PSM) was used to control for confounders. Cox proportional-hazards models and multivariable logistic regression were used to investigate the relationship between norepinephrine treatment and mortality. A total of 927 eligible patients were included: 552 patients in the norepinephrine group and 375 patients in the non-norepinephrine group. After PSM, 222 cases from each group were matched using a 1:1 matching algorithm. Thirty day mortality for patients treated with norepinephrine was significantly higher than for those in the non-norepinephrine group (41% vs. 30%, OR 1.61, 95% CI 1.09-2.39, P = 0.017; HR 1.50, 95% CI 1.09-2.06, P = 0.013). In the multivariable analysis, there was no significant difference between norepinephrine therapy and long-term (90 day, 180 day, or 1 year) mortality (90 day (OR 1.19, 95% CI 0.82-1.74, P = 0.363), 180 day (OR 1.17, 95% CI 0.80-1.70, P = 0.418), 1 year (OR 1.14, 95% CI 0.79-1.66, P = 0.477). Patients in the norepinephrine group required more mechanical ventilation (84% vs. 67%, OR 2.67, 95% CI 1.70-4.25, P < 0.001) and experienced longer ICU stays (median 7 vs. 4 days, OR 7.92, 95% CI 1.40-44.83, P = 0.020) than non-norepinephrine group.
conclusionsCardiogenic shock patients treated with norepinephrine were associated with significantly increased short-term mortality, while no significant difference was found on long-term survival rates. Future trials are needed to validate and explore this association.
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