AUTHOR=Cherbi Miloud , Roubille François , Lamblin Nicolas , Bonello Laurent , Leurent Guillaume , Levy Bruno , Elbaz Meyer , Champion Sebastien , Lim Pascal , Schneider Francis , Cariou Alain , Khachab Hadi , Bourenne Jeremy , Seronde Marie-France , Schurtz Guillaume , Harbaoui Brahim , Vanzetto Gerald , Quentin Charlotte , Delabranche Xavier , Aissaoui Nadia , Combaret Nicolas , Tomasevic Danka , Marchandot Benjamin , Lattuca Benoit , Henry Patrick , Gerbaud Edouard , Bonnefoy Eric , Puymirat Etienne , Maury Philippe , Delmas Clément 

TITLE=One-year outcomes in cardiogenic shock triggered by ventricular arrhythmia: An analysis of the FRENSHOCK multicenter prospective registry

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1092904

DOI=10.3389/fcvm.2023.1092904

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Cardiogenic shock (CS) is a life-threatening condition carrying poor prognosis, potentially triggered by ventricular arrhythmia (VA). Whether the occurrence of VA as trigger of CS worsens the prognosis compared to non-VA triggers  remains  unclear.  The  aim  of  this  study  was  to  evaluate  1-year  outcomes [mortality, heart transplantation, ventricular assist devices (VAD)] between VA-triggered and non-VA-triggered CS.</p></sec><sec><title>Methods</title><p>FRENSHOCK is a prospective multicenter registry including 772 CS patients from 49 centers. One to three triggers can be identified in the registry (ischemic, mechanical complications, ventricular/supraventricular arrhythmia, bradycardia, iatrogenesis, infection, non-compliance). Baseline characteristics, management and 1-year outcomes were analyzed according to the VA-trigger in the CS population.</p></sec><sec><title>Results</title><p>Within 769 CS patients included, 94 were VA-triggered (12.2%) and were compared to others. At 1 year, although there was no mortality difference [42.6 vs. 45.3%, HR 0.94 (0.67–1.30), <italic>p</italic> = 0.7], VA-triggered CS resulted in more heart transplantations and VAD (17 vs. 9%, <italic>p</italic> = 0.02). Into VA-triggered CS group, though there was no 1-year mortality difference between ischemic and non-ischemic cardiomyopathies [42.5 vs. 42.6%, HR 0.97 (0.52–1.81), <italic>p</italic> = 0.92], non-ischemic cardiomyopathy led to more heart transplantations and VAD (25.9 vs. 5%, <italic>p</italic> = 0.02).</p></sec><sec><title>Conclusion</title><p>VA-triggered CS did not show higher mortality compared to other triggers but resulted in more heart transplantation and VAD at 1 year, especially in non-ischemic cardiomyopathy, suggesting the need for earlier evaluation by advanced heart failure specialized team for a possible indication of mechanical circulatory support or heart transplantation.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov</ext-link>, identifier NCT02703038.</p></sec>