加压素对心源性休克患者90天死亡率的影响：一项使用倾向评分加权分析的回顾性队列研究

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics Pub Date : 2025-05-28 DOI:10.1155/cdr/9920490

Christophe Beyls, Thomas Hanquiez, Nicolas Mollet, Yoni Sarfati, Adel Zerima, Souheil Chafiki, Patricia Besserve, Hervé Dupont, Momar Diouf, Osama Abou-Arab, Yazine Mahjoub

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引用次数: 0

摘要

背景：心源性休克（CS）可能导致顽固性血管截瘫状态，在去甲肾上腺素的基础上需要抗利尿激素。抗利尿激素自2022年1月起在法国上市。然而，评估抗利尿激素在CS中的临床影响的数据非常少。目的：在本研究中，我们旨在评估抗利尿激素与CS队列90天死亡率之间的关系。方法：我们在亚眠大学医院进行了一项回顾性单中心研究，比较了两个至少经历CS C期的患者队列：一个历史队列（2018年至2019年）未使用抗利尿激素，另一个当代队列（2022年至2023年）接受抗利尿激素治疗。主要终点为90天死亡率。次要观察指标为ICU住院期间严重不良事件（SAEs）的发生情况。从倾向评分得出的治疗加权逆概率（IPTW）用于减少基线特征的不平衡。结果：201例患者入组：抗利尿激素组59例，未应用抗利尿激素组142例。加压素组的SOFA评分和去甲肾上腺素当量更高(13 [10-16]vs. 12 [9-15]；p = 0.02和0.72(0.21 - -1.51)和0.13 (0.07 - -0.34);p & lt;分别为0.001)。两组90天死亡率无显著差异(n = 31/59 vs. 75/142；P = 0.97)。调整前，抗利尿激素与90天死亡率无关(OR = 0.98 [95% CI 0.50-1.78]；P = 0.87)。加权后，加压素仍与90天死亡率无关(OR = 1.10 [95% CI 0.56-2.17]；P = 0.77)。两组间SAEs发生率无显著差异(n = 57/142 [40%] vs. n = 23/59 [39%]；P = 0.88)。结论：加压素与CS患者的30天死亡率和SAEs无关。

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The Effect of Vasopressin on 90-Day Mortality in Patients With Cardiogenic Shock: A Retrospective Cohort Study Using Propensity Score-Weighted Analysis

Background: Cardiogenic shock (CS) may lead to a refractory vasoplegic state that requires vasopressin on top of norepinephrine. Vasopressin has been available in France since January 2022. However, data assessing the clinical impact of vasopressin in CS are very scarce.

Objective: In this study, we aimed to assess the association between vasopressin and 90-day mortality in a cohort of CS.

Method: We conducted a retrospective, single-center study at Amiens University Hospital comparing two cohorts of patients experiencing at least Stage C of CS: one historical cohort from 2018 to 2019 without vasopressin and a contemporary cohort from 2022 to 2023 treated with vasopressin. The primary outcome was 90-day mortality. The secondary outcome was the occurrence of serious adverse events (SAEs) during ICU stay. Inverse probability of treatment weighting (IPTW) derived from propensity score was used to reduce imbalances in baseline characteristics.

Results: We included 201 patients in the study: 59 in the vasopressin group and 142 in the no vasopressin group. The SOFA score and norepinephrine equivalent were higher in the vasopressin group (13 [10–16] vs. 12 [9–15]; p = 0.02 and 0.72 [0.21–1.51] vs. 0.13 [0.07–0.34]; p < 0.001, respectively). There was no significant difference between the two groups for the 90-day mortality (n = 31/59 vs. 75/142; p = 0.97). Before adjustment, vasopressin was not associated with 90-day mortality (OR = 0.98 [95% CI 0.50–1.78]; p = 0.87). After weighting, vasopressin remained not associated with 90-day mortality (OR = 1.10 [95% CI 0.56–2.17]; p = 0.77). There was no significant difference for SAEs between the two groups (n = 57/142 [40%] vs. n = 23/59 [39%]; p = 0.88).

Conclusion: Vasopressin was not associated with 30-day mortality and SAEs in patients with CS.

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来源期刊

Cardiovascular Therapeutics 医学-心血管系统

CiteScore

5.60

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： Cardiovascular Therapeutics (formerly Cardiovascular Drug Reviews) is a peer-reviewed, Open Access journal that publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of new cardiovascular therapies. Articles on translational research, pharmacogenomics and personalized medicine, device, gene and cell therapies, and pharmacoepidemiology are also encouraged. Subject areas include (but are by no means limited to): Acute coronary syndrome Arrhythmias Atherosclerosis Basic cardiac electrophysiology Cardiac catheterization Cardiac remodeling Coagulation and thrombosis Diabetic cardiovascular disease Heart failure (systolic HF, HFrEF, diastolic HF, HFpEF) Hyperlipidemia Hypertension Ischemic heart disease Vascular biology Ventricular assist devices Molecular cardio-biology Myocardial regeneration Lipoprotein metabolism Radial artery access Percutaneous coronary intervention Transcatheter aortic and mitral valve replacement.