Vasopressors and inotropes in acute myocardial infarction related cardiogenic shock: A systematic review and meta-analysis

26Citations
Citations of this article
82Readers
Mendeley users who have this article in their library.

Abstract

Vasopressors and inotropes are routinely used in acute myocardial infarction (AMI) related cardiogenic shock (CS) to improve hemodynamics. We aimed to investigate the effect of routinely used vasopressor and inotropes on mortality in AMI related CS. A systematic search of MEDLINE, EMBASE and CENTRAL was performed up to 20 February 2019. Randomized and observational studies reporting mortality of AMI related CS patients were included. At least one group should have received the vasopressor/inotrope compared with a control group not exposed to the vasopressor/inotrope. Exclusion criteria were case reports, correspondence and studies including only post-cardiac surgery patients. In total, 19 studies (6 RCTs) were included, comprising 2478 CS patients. The overall quality of evidence was graded low. Treatment with adrenaline, noradrenaline, vasopressin, milrinone, levosimendan, dobutamine or dopamine was not associated with a difference in mortality between therapy and control group. We found a trend toward better outcome with levosimendan, compared with control (RR 0.69, 95% CI 0.47–1.00). In conclusion, we found insufficient evidence that routinely used vasopressors and inotropes are associated with reduced mortality in patients with AMI related CS. Considering the limited evidence, this study emphasizes the need for randomized trials with appropriate endpoints and methodology.

Cited by Powered by Scopus

Get full text

This article is free to access.

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Karami, M., Hemradj, V. V., Ouweneel, D. M., Den Uil, C. A., Limpens, J., Otterspoor, L. C., … Henriques, J. P. S. (2020, July 1). Vasopressors and inotropes in acute myocardial infarction related cardiogenic shock: A systematic review and meta-analysis. Journal of Clinical Medicine. MDPI. https://doi.org/10.3390/jcm9072051

Readers over time

‘20‘21‘22‘23‘24‘2507142128

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 13

62%

Professor / Associate Prof. 4

19%

Lecturer / Post doc 2

10%

Researcher 2

10%

Readers' Discipline

Tooltip

Medicine and Dentistry 21

66%

Nursing and Health Professions 7

22%

Chemistry 3

9%

Decision Sciences 1

3%

Article Metrics

Tooltip
Social Media
Shares, Likes & Comments: 1

Save time finding and organizing research with Mendeley

Sign up for free
0