ArticleEuropean heart journal open2026
Vasoactive intensity predicts mortality beyond SCAI staging in cardiogenic shock.
Article in European heart journal open, 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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Abstract
Aims: Cardiogenic shock (CS) remains associated with high mortality. Severity is traditionally stratified by the Society for Cardiovascular Angiography and Interventions (SCAI) staging system despite substantial heterogeneity within stages. Whether vasoactive therapy intensity or combination provides additional prognostic information beyond SCAI staging remains unknown. This study assessed whether vasoactive support intensity, quantified by the vasoactive-inotropic score (VIS), improves mortality prediction beyond SCAI staging. Methods and results: In this retrospective bicentric cohort, consecutive adults admitted for CS between 2018 and 2023 were included. The VIS was calculated. The primary outcome was 90-day mortality. Multivariable logistic regression models adjusted for baseline severity assessed interactions with SCAI stage and the incremental prognostic value of VIS using nested models. Among 1167 patients, 90-day mortality increased across SCAI stages C, D, and E (20.1%, 27.4%, and 45.6%; Conclusion: Vasoactive intensity quantified by the VIS improved 90-day mortality prediction beyond SCAI staging and the simple count of vasoactive drugs, providing incremental prognostic information beyond SCAI staging.
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