Effect of Early Empagliflozin Initiation in Cardiogenic Shock.

Effect at 3 Months of Early Empagliflozin Initiation in Cardiogenic Shock Patients on Mortality and Rehospitalization. Retrospective Monocentric Trial.

Cardiogenic shock represents a severe condition of heart pump dysfunction. Despite advances in medical management, the mortality rate for this condition remains high. Conventional treatments for cardiovascular diseases have several side effects that make their use impossible in patients with cardiogenic shock.

A new class of drugs has been developed in recent years and is an integral part of the management of patients with chronic heart failure. These are sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors), namely empagliflozin and dapagliflozin. This therapeutic class has proven effective in reducing mortality as well as hospital readmissions for heart failure patients. Given their effectiveness in acute heart failure, which is physiologically closest to the cardiogenic shock population, and their good tolerance, SGLT2 inhibitors are increasingly being prescribed to patients with cardiogenic shock to improve long-term outcomes.

In order to improve medical knowledge and the management of patients in cardiogenic shock, the main objective of this research is to compare, in these patients, the effect of the early introduction of treatment with sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors), in addition to usual care, versus usual care alone, on all-cause mortality and rehospitalization for heart failure at 12 weeks.

Inclusion Criteria:

• Patients over 18 years old;
• Hospitalized in an Intensive Care or Cardiac Intensive Care unit in cardiogenic shock;
• Hospitalized at CHRU of NANCY between 01/01/2018 and 31/12/2023.

Exclusion Criteria:

At admission to intensive care/cardiac intensive care for cardiogenic shock:

• eGFR < 20 ml/min/1.73m²
• Chronic dialysis patient
• Patient on SGLT2 inhibitors prior to admission to intensive care or cardiac intensive care
• Cardiogenic shock:
• a) From peripartum cardiomyopathy, adrenergic, restrictive, or post-embolic
• b) Due to drug-induced cardiotoxicity
• c) Secondary to a cardiac arrest with more than 25 minutes of "low flow" or more than 5 minutes of "no flow" before recovery of stable cardiac activity
• Adult subject under a legal protective measure (guardianship, curatorship, judicial safeguard)