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Article Dans Une Revue European Heart Journal: Acute Cardiovascular Care Année : 2023

Characteristics, management and outcomes of active cancer patients with cardiogenic shock

Hamid Merdji
Bruno Levy
  • Fonction : Auteur
Sebastien Champion
  • Fonction : Auteur
Pascal Lim
Francis Schneider
  • Fonction : Auteur
Alain Cariou
  • Fonction : Auteur
Hadi Khachab
  • Fonction : Auteur
Jeremy Bourenne
  • Fonction : Auteur
Marie-France Seronde
  • Fonction : Auteur
Gerald Vanzetto
  • Fonction : Auteur
Charlotte Quentin
  • Fonction : Auteur
Anais Curtiaud
Jean-Emmanuel Kurtz
  • Fonction : Auteur
Nicolas Combaret
Benjamin Marchandot
Benoit Lattuca
Vincent Bataille
  • Fonction : Auteur
Etienne Puymirat
Eric Bonnefoy
  • Fonction : Auteur
Nadia Aissaoui
  • Fonction : Auteur

Résumé

Aims: Characteristics, management, and outcomes of patients with active cancer admitted for cardiogenic shock remain largely unknown. This study aimed to address this issue and identify the determinants of 30-day and 1-year mortality in a large cardiogenic shock cohort of all etiologies. Methods and results: FRENSHOCK is a prospective multicenter observational registry conducted in French critical care units between April and October 2016. "Active cancer" was defined as a malignancy diagnosed within the previous weeks with planned or ongoing anticancer therapy. Among the 772 enrolled patients (mean age 65.7 ± 14.9 years; 71.5% male), 51 (6.6%) had active cancer. Among them, the main cancer types were solid cancers (60.8%), and hematological malignancies (27.5%). Solid cancers were mainly urogenital (21.6%), gastrointestinal (15.7%), and lung cancer (9.8%). Medical history, clinical presentation, and baseline echocardiography were almost the same between groups. In-hospital management significantly differed: patients with cancers received more catecholamines or inotropes (norepinephrine 72 vs 52%, p=0.005 and norepinephrine-dobutamine combination 64.7 vs 44.5%, p=0.005), but had less mechanical circulatory support (5.9 vs 19.5%, p=0.016). They presented similar 30-day mortality rate (29 vs 26%) but a significantly higher mortality at one-year (70.6 vs 45.2%, p<0.001). In multivariable analysis, active cancer was not associated with 30-day mortality but was significantly associated with 1-year mortality in 30-day survivors (HR 3.61 [1.29 - 10.11], p=0.015). Conclusion: Active cancer patients accounted for almost 7% of all cases of cardiogenic shock. Early mortality was the same regardless active cancer or not, whereas long-term mortality was significantly increased in patients with active cancer.
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Dates et versions

hal-04154866 , version 1 (08-09-2023)

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Hamid Merdji, Justine Gantzer, Laurent Bonello, Nicolas Lamblin, François Roubille, et al.. Characteristics, management and outcomes of active cancer patients with cardiogenic shock. European Heart Journal: Acute Cardiovascular Care, 2023, ⟨10.1093/ehjacc/zuad072⟩. ⟨hal-04154866⟩
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