ArticleEClinicalMedicine2025
Identifying biomarker-driven subphenotypes of cardiogenic shock: analysis of prospective cohorts and randomized controlled trials.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 15 papers.
What it found
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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.
French and EuRopean Outcome Registry in Intensive Care Unit
Optimizing the Use of Vasopressor After Coronary Reperfusion in Cardiogenic Shock Secondary to Myocardial Infarction. Pathophysiological Study Comparing the Efficacy and Cardio-circulatory Tolerability of Epinephrine and Norepinephrine
Pathophysiology and Prognostic Factors in Cardiogenic Shock - CardShock Study
Prospective Randomized Multicenter Study Comparing Immediate Multivessel Revascularization by PCI Versus Culprit Lesion PCI With Staged Non-culprit Lesion Revascularization in Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock
Comparison of Milrinone Versus Dobutamine in a Heterogeneous Population of Critically Ill Patients
Beyond the Syndromic Approach in Critical Care: Identifying Biomarker-driven Subphenotypes of Circulatory Shock
Who cites it
15 citing papers in PubMed.
- The Persistent Challenge of Cardiogenic Shock Complicating Acute Myocardial Infarction: Insights From a Korean Nationwide Registry.Korean circulation journal · 2026Article
- Characterization and 3-Year Survival of Clinical Subtypes and Host Response Phenotypes of Acute Respiratory Failure Requiring Mechanical Ventilation.CHEST critical care · 2026Article
- Identifying clinical subtypes in acute dyspnoea patients admitted to the emergency department: a secondary model-based clustering of prospective cohorts.ESC heart failure · 2026Article
- Blood Count-Based Inflammatory Indices Do Not Improve Prediction of Acute Kidney Injury in Cardiogenic Shock.Journal of clinical medicine research · 2026Review
- Cardiogenic Shock: Clinical Management, Outcomes and Future Directions.Journal of cardiovascular development and disease · 2026Review
- Unsupervised Clustering of Routine Inflammatory Markers in Cardiogenic Shock Reveals Phenotypic Heterogeneity Without Prognostic Utility.Journal of personalized medicine · 2026Article
- Cardiogenic shock: from standardization to precision-a new era in critical care cardiology?Intensive care medicine · 2026Article
- Special topics: heart failure-related cardiogenic shock, valvular heart disease and end-stage renal disease. Part 4 of the International Expert Opinion Series on Acute Heart Failure Management.Heart failure reviews · 2025Review
- Cardiogenic shock syndrome unraveled: understanding the different layers of heterogeneity.Intensive care medicine · 2025Article
- Cardiogenic shock: diagnosis, phenotyping and management.Intensive care medicine · 2025Review
- 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
- AI-Based Predictive Models for Cardiogenic Shock in STEMI: Real-World Data for Early Risk Assessment and Prognostic Insights.Journal of clinical medicine · 2025Article
- Dynamic Predictive Models of Cardiogenic Shock in STEMI: Focus on Interventional and Critical Care Phases.Journal of clinical medicine · 2025Article
- Comparison of different AI systems for diagnosing sepsis, septic shock, and cardiogenic shock: a retrospective study.Scientific reports · 2025Article
- Cardiometabolic shock: understanding the final turns of the downward spiral.Frontiers in cardiovascular medicine · 2025Review
Corrections and comments
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Cardiogenic shock (CS) is a heterogeneous clinical syndrome, making it challenging to predict patient trajectory and response to treatment. This study aims to identify biological/molecular CS subphenotypes, evaluate their association with outcome, and explore their impact on heterogeneity of treatment effect (ShockCO-OP, NCT06376318). Methods: We used unsupervised clustering to integrate plasma biomarker data from two prospective cohorts of CS patients: CardShock (N = 205 [2010-2012, NCT01374867]) and the French and European Outcome reGistry in Intensive Care Units (FROG-ICU) (N = 228 [2011-2013, NCT01367093]) to determine the optimal number of classes. Thereafter, a simplified classifier (Euclidean distances) was used to assign the identified CS subphenotypes in three completed randomized controlled trials (RCTs) (OptimaCC, N = 57 [2011-2016, NCT01367743]; DOREMI, N = 192 [2017-2020, NCT03207165]; and CULPRIT-SHOCK, N = 434 [2013-2017, NCT01927549]) and explore heterogeneity of treatment effect with respect to 28-day mortality (primary outcome). Findings: Four biomarker-driven CS subphenotypes ('adaptive', 'non-inflammatory', 'cardiopathic', and 'inflammatory') were identified separately in the two cohorts. Patients in the inflammatory and cardiopathic subphenotypes had the highest 28-day mortality (p (log-rank test) = 0.0099 and 0.0055 in the CardShock and FROG-ICU cohorts, respectively). Subphenotype membership significantly improved risk stratification when added to traditional risk factors including the Society for Cardiovascular Angiography and Interventions (SCAI) shock stages (increase in Harrell's C-index by 4% ( Interpretation: Subphenotypes with the highest concentration of biomarkers of endothelial dysfunction and inflammation (inflammatory) or myocardial injury/fibrosis (cardiopathic) were associated with mortality independently from the SCAI shock stages. Funding: Dr Sabri Soussi was awarded the Canadian Institutes of Health Research (CIHR) Doctoral Foreign Study Award (DFSA) and the Merit Awards Program (Department of Anesthesiology and Pain Medicine, University of Toronto, Canada) for the current study.
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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.