Acute cardiac care & resuscitationCohort study
Balancing blood pressure and catecholamine support is critical in heart failure-related cardiogenic shock patients
- Retrospective cohort study
- multicentre
- 16 tertiary centres in 5 European countries
Authors' conclusion
In HF-CS, higher catecholamine support independently associates with worse outcomes. Accepting lower blood pressure targets to reduce catecholamine dosage may improve outcomes.
Study context
- Population
- Patients with heart failure-associated cardiogenic shock (HF-CS), 2016–2021
- Participants
- 704 patients
- Exposure
- Higher vs lower catecholamine dose and score/mean arterial pressure (MAP) ratio
- Outcome
- ICU discharge and 30-day mortality by catecholamine dosage (inotropic score)
- Follow-up
- 30 days
Main finding
As reported in the abstract
Higher inotropic score
Higher inotropic scoreEstimate (95% CI)P value
ICU discharge, baseline score
OR 0.78(0.69–0.88)
P < 0.001ICU discharge, summarized score
OR 0.46(0.38–0.56)
P < 0.00130-day mortality, baseline score
HR 1.27(1.15–1.40)
P < 0.00130-day mortality, summarized score
HR 1.83(1.60–2.09)
P < 0.001- Discharged from intensive care unit (ICU)
- 53%
- Died within 30 days
- 48%
Observational data: associations, not effects.
Further findings
Score/MAP ratio thresholds
- Ratio <0.403 µg/kg/min/mmHg associated with higher ICU discharge odds (ceiling effect)
- Ratio <0.426 µg/kg/min/mmHg associated with lower 30-day mortality hazards (no ceiling effect)
Original publication
Balancing blood pressure and catecholamine support is critical in heart failure-related cardiogenic shock patients. Eur J Heart Fail. Published 14 January 2026. doi:10.1093/ejhf/xuag009
Summarised from the published abstract; every number is checked against it