{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:38:43Z","timestamp":1790379523374,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Increasing vasopressor dose is associated with increasing mortality in patients presenting with acute myocardial infarction and cardiogenic shock (AMICS). It is unknown whether the use of vasopressors is independently harmful or if their use is secondary to decreasing intrinsic cardiac power output (CPO). Mechanical circulatory support (MCS) devices enhance CPO. We sought to evaluate the independent impact of increasing vasopressor dose on survival in the National Cardiogenic Shock Initiative (NCSI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The NCSI is a single arm prospective trial evaluating outcomes associated with the use of MCS using Impella in patients with AMICS. Early initiation of MCS placement before percutaneous coronary intervention (PCI) and rapid de\u2010escalation of vasopressors guided by systematic use of invasive hemodynamic measures led to 70% in\u2010hospital survival for the first 300 patients enrolled from July 2016 to December 2019 in 57\u2009U.S. sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hemodynamic measures were obtained immediately after MCS and PCI. Survival curves were constructed based on CPO and use of vasopressors. For patients with CPO \u22640.6\u00a0W, survival was 77.3%, 45.0%, and 35.3% when 0, 1, or\u2009\u2265\u20092 vasopressors were used (<jats:italic>p\u2009=<\/jats:italic>\u00a00.02). Similarly, for patients with CPO &gt;0.6\u00a0W survival was 81.7%, 72.6%, and 56.8%, respectively (<jats:italic>p\u2009=<\/jats:italic>\u00a00.01). Logistic regression analysis demonstrated that increasing vasopressor requirements were independently associated with increasing mortality (<jats:italic>p\u2009=<\/jats:italic>\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increasing vasopressor requirement is associated with increased mortality in AMICS independent of underlying CPO. Methods to decrease the need for vasopressors may enhance survival in AMICS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29895","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T17:34:34Z","timestamp":1628012074000},"page":"650-657","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Vasopressors independently associated with mortality in acute myocardial infarction and cardiogenic shock"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3486-6753","authenticated-orcid":false,"given":"Mir B.","family":"Basir","sequence":"first","affiliation":[{"name":"Cardiology Henry Ford Health System  Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Lemor","sequence":"additional","affiliation":[{"name":"Cardiology Henry Ford Health System  Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gorgis","sequence":"additional","affiliation":[{"name":"Cardiology Henry Ford Health System  Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Cardiology University of Virginia  Charlottesville VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8037-7021","authenticated-orcid":false,"given":"Behnam","family":"Tehrani","sequence":"additional","affiliation":[{"name":"Cardiology Inova Heart and Vascular Institute  Fairfax VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5656-4401","authenticated-orcid":false,"given":"Alexander G.","family":"Truesdell","sequence":"additional","affiliation":[{"name":"Cardiology Inova Heart and Vascular Institute  Fairfax VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"Cardiology Loma Linda University Medical Center  Loma LInda VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kolski","sequence":"additional","affiliation":[{"name":"Cardiology St. Joseph Hospital of Orange  Orange CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirit","family":"Patel","sequence":"additional","affiliation":[{"name":"Cardiology St. Joseph Mercy Oakland  Pontiac MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Gelormini","sequence":"additional","affiliation":[{"name":"Cardiology Mercy Hospital of Buffalo  Buffalo NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Todd","sequence":"additional","affiliation":[{"name":"Cardiology Fort Sanders Medical Center  Knoxville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lasorda","sequence":"additional","affiliation":[{"name":"Cardiology Allegheny General Hospital  Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Smith","sequence":"additional","affiliation":[{"name":"Cardiology UMass Memorial Medical Center  Worcester MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3467-1737","authenticated-orcid":false,"given":"Robert","family":"Riley","sequence":"additional","affiliation":[{"name":"Cardiology Christ Hospital  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Marso","sequence":"additional","affiliation":[{"name":"Cardiology Overland Park Regional Medical Center &amp; Research Medical Center  Overland Park KS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Federici","sequence":"additional","affiliation":[{"name":"Cardiology Presbyterian Hospital  Alburqurque NM USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8302-6796","authenticated-orcid":false,"given":"Navin K.","family":"Kapur","sequence":"additional","affiliation":[{"name":"Cardiology Tufts Medical Center  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Cardiology Henry Ford Health System  Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The National Cardiogenic Shock Initiative Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.019"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000525"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907118"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181ffe0eb"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.051"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.11.037"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1387-1"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.08.005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.728840"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.03.060"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.11.014"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.29895","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.29895","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.29895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T22:21:26Z","timestamp":1692570086000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.29895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,3]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1002\/ccd.29895"],"URL":"https:\/\/doi.org\/10.1002\/ccd.29895","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,3]]},"assertion":[{"value":"2021-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}