{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:35:32Z","timestamp":1794000932557,"version":"4.8.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","funder":[{"DOI":"10.13039\/100000050","name":"HHS | NIH | National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["T32HL007604"],"award-info":[{"award-number":["T32HL007604"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Associations of early changes in vasoactive support with cardiogenic shock (CS) mortality remain incompletely defined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>The Critical Care Cardiology Trials Network is a multicenter registry of cardiac intensive care units. Patients admitted with CS (2018\u20132023) had vasoactive dosing assessed at 4 and 24 hours from cardiac intensive care unit admission and quantified by the vasoactive-inotropic score (VIS). Prognostic associations of VIS at both time points, as well as change in VIS from 4 to 24 hours, were examined. Interaction testing was performed based on mechanical circulatory support status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Among 3665 patients, 82% had a change in VIS &lt;10, with 7% and 11% having a \u226510-point increase and decrease from 4 to 24 hours, respectively. The 4 and 24-hour VIS were each associated with cardiac intensive care unit mortality (13%\u201345% and 11%\u201373% for VIS &lt;10 to \u226540, respectively;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              <jats:sub>trend<\/jats:sub>\n              &lt;0.0001 for each). Stratifying by the 4-hour VIS, changes in VIS from 4 to 24 hours had a graded association with mortality, ranging from a 2- to &gt;4-fold difference in mortality comparing those with a \u226510-point increase to \u226510-point decrease in VIS (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              <jats:sub>trend<\/jats:sub>\n              &lt;0.0001). The change in VIS alone provided good discrimination of cardiac intensive care unit mortality (C-statistic, 0.72 [95% CI, 0.70\u20130.75]) and improved discrimination of the 24-hour Sequential Organ Failure Assessment score (0.72 [95% CI, 0.69\u20130.74] to 0.76 [95% CI, 0.74\u20130.78]) and the clinician-assessed Society for Cardiovascular Angiography and Interventions shock stage (0.72 [95% CI, 0.70\u20130.74] to 0.77 [95% CI, 0.75\u20130.79]). Although present in both groups, the mortality risk associated with VIS was attenuated in patients managed with versus without mechanical circulatory support (odds ratio per 10-point higher 24-hour VIS, 1.36 [95% CI, 1.23\u20131.49] versus 1.84 [95% CI, 1.69\u20132.01];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Early changes in the magnitude of vasoactive support in CS are associated with a gradient of risk for mortality. These data suggest that early VIS trajectory may improve CS prognostication, with the potential to be leveraged for clinical decision-making and research applications in CS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.124.011736","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T13:30:45Z","timestamp":1712583045000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Early Serial Assessment of Aggregate Vasoactive Support and Mortality in Cardiogenic Shock: Insights From the Critical Care Cardiology Trials Network Registry"],"prefix":"10.1161","volume":"17","author":[{"given":"Siddharth M.","family":"Patel","sequence":"first","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.P., D.D.B., E.A.B., V.M.B.-Z., C.G., J.-G.P., D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0366-5492","authenticated-orcid":true,"given":"David D.","family":"Berg","sequence":"additional","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.P., D.D.B., E.A.B., V.M.B.-Z., C.G., J.-G.P., D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5559-8172","authenticated-orcid":true,"given":"Erin A.","family":"Bohula","sequence":"additional","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.P., D.D.B., E.A.B., V.M.B.-Z., C.G., J.-G.P., D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian M.","family":"Baird-Zars","sequence":"additional","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.P., D.D.B., E.A.B., V.M.B.-Z., C.G., J.-G.P., D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6353-6780","authenticated-orcid":true,"given":"Gregory W.","family":"Barsness","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN (G.W.B., J.C.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2788-7532","authenticated-orcid":true,"given":"Sunit-Preet","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Vincent Heart Center, Indianapolis, IN (S.-P.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9829-7898","authenticated-orcid":true,"given":"Meshe D.","family":"Chonde","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (M.D.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard A.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Westchester Medical Center, Valhalla, NY (H.A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8507-9624","authenticated-orcid":true,"given":"Curtis","family":"Ginder","sequence":"additional","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.P., D.D.B., E.A.B., V.M.B.-Z., C.G., J.-G.P., D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob C.","family":"Jentzer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN (G.W.B., J.C.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Kontos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Virginia Commonwealth University, Richmond (M.C.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-1492","authenticated-orcid":true,"given":"P. Elliott","family":"Miller","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Yale University, New Haven, CT (P.E.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-8187","authenticated-orcid":true,"given":"L. Kristin","family":"Newby","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (L.K.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2325-8317","authenticated-orcid":true,"given":"Connor G.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of California San Francisco (C.G.O.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4615-1747","authenticated-orcid":true,"given":"Jeong-Gun","family":"Park","sequence":"additional","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.P., D.D.B., E.A.B., V.M.B.-Z., C.G., J.-G.P., D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6408-1821","authenticated-orcid":true,"given":"Matthew J.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Northwell Health, Zucker School of Medicine, New Hyde Park, NY (M.J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8148-2317","authenticated-orcid":true,"given":"Barbara A.","family":"Pisani","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC (B.A.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0316-9026","authenticated-orcid":true,"given":"Brian J.","family":"Potter","sequence":"additional","affiliation":[{"name":"Cardiology Service, Department of Medicine, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al Research Center and Cardiovascular Center, Quebec, QC, Canada (B.J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Utah, Salt Lake City (K.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8342-3222","authenticated-orcid":true,"given":"Jeffrey J.","family":"Teuteberg","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (J.J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3460-5169","authenticated-orcid":true,"given":"Jason N.","family":"Katz","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, New York University School of Medicine, New York (J.N.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6688-828X","authenticated-orcid":true,"given":"Sean","family":"van Diepen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, AB, Canada (S.v.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-5382","authenticated-orcid":true,"given":"David A.","family":"Morrow","sequence":"additional","affiliation":[{"name":"Levine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (S.M.P., D.D.B., E.A.B., V.M.B.-Z., C.G., J.-G.P., D.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000525"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001390"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004815"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.122.009714"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000002123"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.01.018"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001076"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.09.828"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.2467"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005618"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.08.014"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181b806fc"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208410"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.062949"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307227"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.124.011736","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T21:08:54Z","timestamp":1748552934000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.124.011736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.124.011736"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.124.011736","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2024-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}