Evidence map›Paper›PMID 41257682›Full record

ArticleBMC cardiovascular disorders2025

Early initiation of guideline-directed medical therapy in patients with cardiogenic shock supported with Impella

Junichiro Yokawa, Tetsuo Nishikawa, Masaya Shimojima, Miho Nakamura, Yuma Amino, Koji Sato, Yoshinao Koshida, Takumi Taniguchi

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Junichiro YokawaDepartment of Intensive Care Unit, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan. jun-jun-116@staff.kanazawa-u.ac.jp.
Tetsuo NishikawaDepartment of Intensive Care Unit, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
Masaya ShimojimaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Miho NakamuraDepartment of Intensive Care Unit, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
Yuma AminoDepartment of Intensive Care Unit, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
Koji SatoDepartment of Intensive Care Unit, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
Yoshinao KoshidaDepartment of Intensive Care Medicine, Toyama Prefectural Central Hospital, Toyama, Japan.
Takumi TaniguchiDepartment of Intensive Care Unit, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDetermining the optimal timing for initiating guideline-directed medical therapy (GDMT) in survivors of cardiogenic shock remains a clinical challenge. Clinicians must balance the urgency of early intervention to prevent adverse remodeling with the risk of hemodynamic instability. This study tested the hypothesis that initiating GDMT early during the intensive care unit (ICU) stay is associated with improved 6-month clinical outcomes in this high-risk population.

methodsIn a retrospective, two-center study of 42 survivors of Impella

resultsThe high-score group demonstrated significantly superior 6-month event-free survival compared to the low-score group (log-rank p < 0.001). Additionally, this group achieved higher GDMT scores at hospital discharge (median: 8.0 vs. 2.0, p < 0.001), with a greater proportion achieving a score ≥ 5 (83.3% vs. 27.8%, p < 0.001).

conclusionOur findings suggest that early initiation of GDMT during ICU stabilization is associated with improved 6-month outcomes in survivors of cardiogenic shock. This hypothesis-generating study provides a rationale for future prospective trials to validate this goal-directed strategy.

Indexed as

Cardiovascular AgentsGuideline AdherenceHeart-Assist DevicesPractice Guidelines as TopicProsthesis ImplantationShock, CardiogenicTime-to-TreatmentAgedAged, 80 and overFemaleHumansMaleMiddle AgedPatient ReadmissionProgression-Free SurvivalProsthesis DesignCardiovascular AgentsCardiac intensive careCardiogenic shockGuideline-directed medical therapyHeart failureImpellaIntensive care unit

Identifiers

PMID41257682
PMCPMC12628905

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