In one paragraphArticle in Circulation. Heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
2 · The registryThe trial behind it
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4 · The recordCorrections and comments
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5 · Who and what moneyAuthors and funding
39 authors.
David E HamiltonDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (D.E.H., J.L.S., Z.E.M., S.K.A., S.W.K., A.D.T.).ORCID 0000-0001-7626-2494 Jackson L ShriverDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (D.E.H., J.L.S., Z.E.M., S.K.A., S.W.K., A.D.T.).ORCID 0000-0002-6652-104X Siddharth M PatelTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.M.P., J.-G.P., D.D.B., E.A.B., D.A.M.).ORCID 0000-0002-4637-4361 Jeong-Gun ParkTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.M.P., J.-G.P., D.D.B., E.A.B., D.A.M.).ORCID 0000-0003-4615-1747 Zoe E MichosDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (D.E.H., J.L.S., Z.E.M., S.K.A., S.W.K., A.D.T.).ORCID 0009-0003-6057-4786 Sarah K AdieDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (D.E.H., J.L.S., Z.E.M., S.K.A., S.W.K., A.D.T.).ORCID 0000-0001-6218-2784 Carlos L AlviarThe Leon H. Charney Division of Cardiology, New York University School of Medicine, NY (C.L.A., J.N.K.).
Christopher F BarnettDivision of Cardiology, Department of Medicine, University of California San Francisco, CA (C.F.B.).ORCID 0000-0003-1095-5794 David D BergTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.M.P., J.-G.P., D.D.B., E.A.B., D.A.M.).ORCID 0000-0002-0366-5492 Erin A BohulaTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.M.P., J.-G.P., D.D.B., E.A.B., D.A.M.).ORCID 0000-0002-5559-8172 Lori B DanielsDivision of Cardiovascular Medicine, Department of Medicine, University of California, San Diego (L.B.D.).ORCID 0000-0002-4841-9922 Mark W DodsonDepartment of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, UT (M.W.D.).ORCID 0000-0002-4709-1048 Umesh GidwaniCardiovascular Institute and Fuster Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY (U.G.).ORCID 0000-0002-8631-2819 Michael GoldfarbDivision of Cardiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada (M.G.).ORCID 0000-0001-9790-1232 Jason N KatzThe Leon H. Charney Division of Cardiology, New York University School of Medicine, NY (C.L.A., J.N.K.).ORCID 0000-0002-3460-5169 Scott W KetchamDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (D.E.H., J.L.S., Z.E.M., S.K.A., S.W.K., A.D.T.).ORCID 0000-0002-5231-4111 Evan S LeibnerDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sanai, New York, NY (E.S.L.).ORCID 0000-0002-0490-1389 Daniel B LoriauxDivision of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC (D.B.L.).ORCID 0000-0002-2686-1170 Adriana LukDivision of Cardiology, Department of Medicine, University of Toronto and the Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Ontario, Canada (A.L.).ORCID 0000-0003-3042-4210 Srini V MukundanKnight Cardiovascular Institute, Oregon Health and Science University, Portland, OR (S.V.M.).ORCID 0009-0003-0973-7359 Alexander I PapolosDepartments of Cardiology and Critical Care, MedStar Washington Hospital Center, Washington DC (A.I.P.).ORCID 0000-0001-6045-5988 Barbara A PisaniSection of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (B.A.P.).ORCID 0000-0002-8148-2317 Alastair G ProudfootDepartment of Perioperative Medicine, Barts Heart Centre, London, United Kingdom (A.G.P.).ORCID 0000-0001-9935-0438 Robert O RoswellNorthwell Health Zucker School of Medicine at Hofstra, Lenox Hill Hospital, New York, NY (R.O.R.).ORCID 0000-0003-4358-6534 Kevin S ShahDivision of Cardiology, Department of Medicine, University of Utah, Salt Lake City (K.S.S.).ORCID 0000-0002-3012-9943 Michael A SolomonCritical Care Medicine Department, National Institutes of Health Clinical Center and Cardiovascular Branch, National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, MD (M.A.S.).ORCID 0000-0001-7400-6614 Matthew I TomeyZena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, NY (M.I.T.).ORCID 0000-0001-5626-0467 Sean van DiepenDepartment of Critical Care Medicine, Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (S.v.D.).ORCID 0000-0002-6688-828X Sammy ZakariaDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (S.Z.).ORCID 0000-0002-1054-4410 David A MorrowTIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.M.P., J.-G.P., D.D.B., E.A.B., D.A.M.).ORCID 0000-0002-9589-5382 Andrea D ThompsonDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (D.E.H., J.L.S., Z.E.M., S.K.A., S.W.K., A.D.T.).ORCID 0000-0001-8798-2024 CCCTN Investigators
Funding
Missense Variants in Myosin Binding Protein C that Cause Hypertrophic CardiomyopathyR01HL167524 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI Sharlene M Day · 2023 to 2026
$2.8MPathogenic mechanisms of myosin binding protein C missense variants within hypertrophic cardiomyopathyK08HL163328 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Andrea Dooley Thompson · 2022 to 2026
$837kNHLBI NIH HHS K08 HL163328NHLBI NIH HHS R01 HL167524
6 · The paper itselfAbstract
backgroundThe paucity of data to guide selection of specific vasoactive agents in patients with cardiogenic shock (CS) may lead to variability in practice patterns. The level of variability and specific factors that are associated with the use of vasoactive medications and inodilators have not been previously described.
methodsThe CCCTN (Critical Care Cardiology Trials Network) is an international, multicenter network of cardiac intensive care units (CICUs) coordinated by the Thrombolysis in Myocardial Infarction Study Group. This analysis included CICU admissions for CS from 2019 to 2023. Variation in the use of inodilator treatment (dobutamine/milrinone) was assessed with multivariable mixed-effects logistic modeling.
resultsA total of 3282 admissions from 37 CICUs comprised the analysis cohort. The use of vasoactive medications, including inodilator treatment, varied substantially across institutions. Patient-level variables associated with greater use of inodilators included history of heart failure (odds ratio, 1.98 [95% CI, 1.61-2.44]), biventricular failure (1.59 [95% CI, 1.27-2.00]), Society of Cardiovascular Angiography and Interventions stage D (1.34 [95% CI, 1.07-1.68]), valvular disease (1.34 [95% CI, 1.03-1.74]), and male sex (1.23 [95% CI, 1.02-1.49]). Variables associated with less inodilator use included cardiac arrest (0.33 [95% CI, 0.27-0.42]), right ventricular failure (0.50 [95% CI, 0.33-0.73]), Society of Cardiovascular Angiography and Interventions stage E (0.57 [95% CI, 0.41-0.81]), acute myocardial infarction-CS (0.71 [95% CI, 0.56-0.90]), peripheral arterial disease (0.73 [95% CI, 0.54-0.99]), older age (0.77 [95% CI, 0.72-0.83], per 10-year increase), and estimated glomerular filtration rate (0.96 [95% CI, 0.93-0.99], per 10 mL/min per 1.73 m
conclusionsThere is significant variation in vasoactive treatment and inodilator use in CS. Variation in inodilator use was associated with patient-level factors and with substantial individual CICU practice variation. Such variability underscores the need for additional high-quality evidence to guide vasoactive treatment strategies in CS.
Indexed as
Cardiotonic AgentsCritical CarePractice Patterns, Physicians'Shock, CardiogenicVasoconstrictor AgentsAgedFemaleHumansMaleMiddle AgedTreatment OutcomeCardiotonic AgentsVasoconstrictor Agentsangiographycritical careheart failureodds ratioshock
Identifiers
PMID42093634
PMCPMC13240787
What OpenQuestion holds
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