Patients near to cardiogenic shock (CS) but without hypotension have similar prognosis when compared to patients with classic CS: Is it time for redefine CS? A FRENSHOCK multicenter registry analysis

Background Classical definition of cardiogenic shock(CS) combine a systolic blood pressure (SBP) Methods FRENSHOCK was a multicenter, prospective, observational survey realized between 04 and 10.2016 in 48 centers in France. Patients were included if they met the criteria below: – a low cardiac output(SBP 2 on TTE or Swan-Ganz); – clinical, radiological, biological (NTproBNP or BNP), echocardiography, or invasive hemodynamics overload signs; – a clinical and/or biological hypoperfusion (lactates > 2 mmol/L, hepatic or renal failure). Results A total of 772 patients were included (male 72%, median age 66y): 678 with SBP P = 0.001), but less by dobutamine(71 vs 80%, P = 0.002), norepinephrine (21 vs 58%, P = 0.01), epinephrine (4 vs 13%, P = 0.012), invasive mechanical ventilation (15 vs 41%, P P P = 0.035). At 30 days, no difference in mortality, heart transplantation and/or VAD implantation was observed ( Fig. 1 ). Conclusion Normotensive patients with low cardiac output, overload and hypoperfusion signs present similar prognosis to classical CS. So, current definitions for CS could be challenged to avoid underestimate these patients.