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Acute cardiac care & resuscitationSecondary analysis

Early clinical recovery in STEMI cardiogenic shock: insights from the DanGer shock trial

Eur Heart J Acute Cardiovasc CarePublished

  • post hoc exploratory analysis of the DanGer Shock trial
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Authors' conclusion

The DanGer Shock trial showed a survival benefit of mAFP use in STEMI-CS, yet about one-third of SoC patients experienced rapid haemodynamic recovery. These ‘Fast Recovery’ patients were characterized by higher LVEF, younger age, and lower lactate, however discrimination between patients with and without rapid recovery was modest. Distinguishing patients who will recover rapidly remains challenging and warrants further investigation.

Study context

Population
Patients with ST-elevation acute myocardial infarction complicated by cardiogenic shock (STEMI-CS) randomized in the DanGer Shock trialpatients analysed · SoC 176 · microaxial flow pump (mAFP) 179
Participants
355 patients
Comparison
SoC vs mAFP
  • SoCn = 176
  • mAFPn = 179reference

Primary result

As reported in the abstract

'Fast Recovery' (CICU discharge alive within 3 days of randomization) · 3 days

Further findings

OutcomeHR (95% CI)
Early CICU discharge · through day 3 · favoured SoC2.27 (1.48–3.49)

Median CICU stay beyond day 3

Deaths by day 3

Deaths by day 3 — deaths occurred by day 3
94
  • 'Fast Recovery' patients vs patients with longer cardiac intensive care unit (CICU) stays: 'Fast Recovery' inotropic support 44% · mechanical ventilation 35% · 180-day mortality 9%
  • 'Fast Recovery' patients vs patients with longer CICU stays: longer CICU stays inotropic support 85% · mechanical ventilation 82% · 180-day mortality 46%
  • 'Fast Recovery' patients vs patients with longer CICU stays: 180-day mortality P < 0.001

Early CICU discharge · through day 3

no difference thereafter

Factors associated with 'Fast Recovery' in the SoC arm

lower age, initial higher LVEF, lower heart rate, and lower lactate

Model discrimination

AUROC optimism-corrected
0.74
  • modest

Original publication

Early clinical recovery in STEMI cardiogenic shock: insights from the DanGer shock trial. Eur Heart J Acute Cardiovasc Care. Published 24 March 2026. doi:10.1093/ehjacc/zuag029
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Summarised from the published abstract; every number is checked against it