Hemoglobin in cardiogenic shock: the lower, the poorer survival
Abstract Background Cardiogenic shock (CS) is a severe hemodynamic condition with high mortality. Although extremely frequent in daily practice, the impact of anemia in CS is largely unknown. This study focuses on the consequences of low hemoglobin (Hb) level on the outcomes of CS patients. Methods...
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BMC
2025-06-01
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| Series: | Journal of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s40560-025-00805-y |
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| author | Miloud Cherbi Bruno Levy Hamid Merdji Etienne Puymirat Eric Bonnefoy Fanny Vardon Meyer Elbaz Olivier Morel Guillaume Leurent Nicolas Lamblin Edouard Gerbaud Paul Gautier François Roubille Clément Delmas |
| author_facet | Miloud Cherbi Bruno Levy Hamid Merdji Etienne Puymirat Eric Bonnefoy Fanny Vardon Meyer Elbaz Olivier Morel Guillaume Leurent Nicolas Lamblin Edouard Gerbaud Paul Gautier François Roubille Clément Delmas |
| author_sort | Miloud Cherbi |
| collection | DOAJ |
| description | Abstract Background Cardiogenic shock (CS) is a severe hemodynamic condition with high mortality. Although extremely frequent in daily practice, the impact of anemia in CS is largely unknown. This study focuses on the consequences of low hemoglobin (Hb) level on the outcomes of CS patients. Methods FRENSHOCK is a prospective registry including 772 CS patients from 49 centers. One-month and one-year mortalities were analyzed according to the admission level of Hb. Results Among 754 patients, 71.8% were male, with a mean age of 65.8 (± 14.8) years, and 361 (47.9%) presenting with anemia. Four groups were defined, depending on admission Hb levels by quartiles: Q1: Hb < 11.0 g/dL, Q2: Hb 11–12.6 g/dL, Q3: Hb > 12.6–14 g/dL, and Q4: Hb > 14.0 g/dL. Patients from the Q1 group required more frequent renal replacement therapy and norepinephrine. A significant increase in all-cause mortality was observed across Hb quartiles at 1 month (Ptrend = 0.035) and 1 year (Ptrend < 0.01). Q1 patients had 1.64 times higher mortality at 1 month (1.09–2.47, p = 0.02) and 2.53 times higher mortality at 1 year (1.84–3.49, p < 0.01) compared to Q4. The negative effect of low Hb level was confirmed in multivariate Cox regression adjusted for baseline characteristics, and was stronger in men, non-ischemic CS, patients without CKD and patients aged < 67 years. Conclusion Anemia is a common condition frequently intertwined with CS worsening both short- and long-term mortality. Further randomized studies are warranted to understand its mechanisms and adapt the transfusion strategy. Graphical Abstract |
| format | Article |
| id | doaj-art-865127d2da5e48ff918341f7d6728562 |
| institution | OA Journals |
| issn | 2052-0492 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Intensive Care |
| spelling | doaj-art-865127d2da5e48ff918341f7d67285622025-08-20T02:37:58ZengBMCJournal of Intensive Care2052-04922025-06-0113111410.1186/s40560-025-00805-yHemoglobin in cardiogenic shock: the lower, the poorer survivalMiloud Cherbi0Bruno Levy1Hamid Merdji2Etienne Puymirat3Eric Bonnefoy4Fanny Vardon5Meyer Elbaz6Olivier Morel7Guillaume Leurent8Nicolas Lamblin9Edouard Gerbaud10Paul Gautier11François Roubille12Clément Delmas13Intensive Cardiac Care Unit, University Hospital of ToulouseMedical Intensive Care Unit Brabois, INSERM U1116, Institut Lorrain du Cœur Et Des Vaisseaux, CHRU de Nancy, Université de LorraineMedical Intensive Care Unit, Strasbourg University Hospital, Nouvel Hôpital CivilDepartment of Cardiology, Hôpital Européen Georges PompidouIntensive Cardiac Care Unit, Hospice Civils de LyonUniversité Paul Sabatier - Toulouse IIIIntensive Cardiac Care Unit, University Hospital of ToulouseDepartment of Cardiology, University Hospital of StrasbourgDepartment of Cardiology, CHU Rennes, Inserm, LTSI - UMR 1099, Univ Rennes 1Department of Cardiology, CHU Lille, Inserm, Institut Pasteur Lille, U1167, Univ. LilleIntensive Cardiac Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut LévêqueIntensive Cardiac Care Unit, University Hospital of ToulouseDepartment of Cardiology, CHU MontpellierIntensive Cardiac Care Unit, University Hospital of ToulouseAbstract Background Cardiogenic shock (CS) is a severe hemodynamic condition with high mortality. Although extremely frequent in daily practice, the impact of anemia in CS is largely unknown. This study focuses on the consequences of low hemoglobin (Hb) level on the outcomes of CS patients. Methods FRENSHOCK is a prospective registry including 772 CS patients from 49 centers. One-month and one-year mortalities were analyzed according to the admission level of Hb. Results Among 754 patients, 71.8% were male, with a mean age of 65.8 (± 14.8) years, and 361 (47.9%) presenting with anemia. Four groups were defined, depending on admission Hb levels by quartiles: Q1: Hb < 11.0 g/dL, Q2: Hb 11–12.6 g/dL, Q3: Hb > 12.6–14 g/dL, and Q4: Hb > 14.0 g/dL. Patients from the Q1 group required more frequent renal replacement therapy and norepinephrine. A significant increase in all-cause mortality was observed across Hb quartiles at 1 month (Ptrend = 0.035) and 1 year (Ptrend < 0.01). Q1 patients had 1.64 times higher mortality at 1 month (1.09–2.47, p = 0.02) and 2.53 times higher mortality at 1 year (1.84–3.49, p < 0.01) compared to Q4. The negative effect of low Hb level was confirmed in multivariate Cox regression adjusted for baseline characteristics, and was stronger in men, non-ischemic CS, patients without CKD and patients aged < 67 years. Conclusion Anemia is a common condition frequently intertwined with CS worsening both short- and long-term mortality. Further randomized studies are warranted to understand its mechanisms and adapt the transfusion strategy. Graphical Abstracthttps://doi.org/10.1186/s40560-025-00805-yCardiogenic shockAnemiaHemoglobinPrognosisMortality |
| spellingShingle | Miloud Cherbi Bruno Levy Hamid Merdji Etienne Puymirat Eric Bonnefoy Fanny Vardon Meyer Elbaz Olivier Morel Guillaume Leurent Nicolas Lamblin Edouard Gerbaud Paul Gautier François Roubille Clément Delmas Hemoglobin in cardiogenic shock: the lower, the poorer survival Journal of Intensive Care Cardiogenic shock Anemia Hemoglobin Prognosis Mortality |
| title | Hemoglobin in cardiogenic shock: the lower, the poorer survival |
| title_full | Hemoglobin in cardiogenic shock: the lower, the poorer survival |
| title_fullStr | Hemoglobin in cardiogenic shock: the lower, the poorer survival |
| title_full_unstemmed | Hemoglobin in cardiogenic shock: the lower, the poorer survival |
| title_short | Hemoglobin in cardiogenic shock: the lower, the poorer survival |
| title_sort | hemoglobin in cardiogenic shock the lower the poorer survival |
| topic | Cardiogenic shock Anemia Hemoglobin Prognosis Mortality |
| url | https://doi.org/10.1186/s40560-025-00805-y |
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