{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:27:10Z","timestamp":1789547230653,"version":"build-2803163510"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Cardiogenic shock (CS) is a state of low cardiac output resulting in end-organ hypoperfusion. Despite high in-hospital mortality rates, little evidence exists regarding the optimal mean arterial pressure (MAP) target in CS. We therefore evaluated the relationship between achieved MAP and clinical outcomes in patients with CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We performed a post hoc analysis of the CAPITAL DOREMI trial: a randomized, double-blind trial comparing dobutamine to milrinone in patients with CS. We divided patients into a high MAP group (average MAP \u2265 70\u2009mmHg over the 36\u2009h following randomization), and a low MAP group (average MAP &amp;lt; 70\u2009mmHg). Our primary outcome included in-hospital all-cause mortality, resuscitated cardiac arrest, need for cardiac transplantation or mechanical circulatory support, non-fatal myocardial infarction, transient ischaemic attack or stroke, or initiation of renal replacement therapy. In total, 71 (37.0%) patients achieved an average MAP &amp;lt; 70\u2009mmHg, and 121 (63.0%) achieved an average MAP \u2265 70\u2009mmHg. The primary outcome occurred in 48 (67.6%) patients in the low MAP group and 51 (42.2%) patients in the high MAP group [adjusted relative risk (aRR) 0.70; 95% confidence interval (CI) 0.53\u20130.92; P\u2009=\u20090.01]. All-cause mortality occurred in 41 (57.8%) and 35 (28.9%) patients in the low and high MAP groups, respectively (aRR 0.56; 95% CI 0.40\u20130.79; P\u2009&amp;lt;\u20090.01). There were no significant differences in any secondary outcomes between each group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with CS treated with inotrope therapy, low MAP is associated with worse clinical outcomes. Randomized data evaluating optimal MAP targets in CS is needed to guide medical therapy.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjacc\/zuab052","type":"journal-article","created":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T11:07:34Z","timestamp":1624792054000},"page":"712-720","source":"Crossref","is-referenced-by-count":28,"title":["The association between mean arterial pressure and outcomes in patients with cardiogenic shock: insights from the DOREMI trial"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9294-4268","authenticated-orcid":false,"given":"Simon","family":"Parlow","sequence":"first","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Di Santo","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, Ontario, K1G 5Z3,\u00a0Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Mathew","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G","family":"Jung","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Faculty of Medicine, University of Ottawa,\u00a0Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, Ontario, K1H 8M5, Canada"},{"name":"Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Room #3206, Ottawa, Ontario, K1H 8M5,\u00a0Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Simard","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Room #3206, Ottawa, Ontario, K1H 8M5,\u00a0Canada"},{"name":"Department of Cardiovascular Diseases, Mayo Clinic School of Medicine,\u00a0200 First St. SW, Rochester, Minnesota, 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Gillmore","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ottawa,\u00a0Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, Ontario, K1H 8M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brennan","family":"Mao","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ottawa,\u00a0Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, Ontario, K1H 8M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abdel-Razek","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4350-1652","authenticated-orcid":false,"given":"F Daniel","family":"Ramirez","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A","family":"Marbach","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, 800 Washington Street, Boston, Massachusetts, 02111,\u00a0USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Dick","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Glover","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan J","family":"Russo","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Froeschl","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marino","family":"Labinaz","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M","family":"Fernando","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Critical Care, Department of Medicine, University of Ottawa,\u00a0501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Hibbert","sequence":"additional","affiliation":[{"name":"CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada"},{"name":"Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Room #3206, Ottawa, Ontario, K1H 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