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Multicenter Study
. 2025 Jun:87:155028.
doi: 10.1016/j.jcrc.2025.155028. Epub 2025 Jan 22.

Cardiogenic shock in patients with active onco-hematological malignancies: A multicenter retrospective study

Mickael Lescroart  1 , Hélène Kemp  2 , Olivier Imauven  3 , Jean Herlé Raphalen  4 , François Bagate  5 , Julien Schmidt  6 , Nahema Issa  7 , Maxens Decavele  8 , Anne-Sophie Moreau  9 , Fabienne Tamion  10 , Bruno Mourvillier  11 , Laure Calvet  12 , Emmanuel Canet  13 , Christine Lebert  14 , Stephanie Pons  15 , Guillaume Lacave  16 , Florent Wallet  17 , Hadrien Winiszewski  18 , Hamid Merdji  19 , Marc Pineton De Chambrun  20 , Laurent Argaud  21 , Antoine Kimmoun  22 , Guillaume Dumas  23 , Lara Zafrani  24
Affiliations
Multicenter Study

Cardiogenic shock in patients with active onco-hematological malignancies: A multicenter retrospective study

Mickael Lescroart et al. J Crit Care. 2025 Jun.

Abstract

Purpose: Onco-hematological (OH) patients face significant cardiovascular risks due to malignancy and drug toxicity. Data are limited on the characteristics and outcomes of OH patients with cardiogenic shock (CS) in intensive care units (ICUs).

Methods: This multicenter retrospective study included 214 OH patients with CS across 22 ICUs (2010-2021). The objectives were to (i) identify risk factors for 30-day mortality, (ii) describe early and long-term outcomes, and (iii) assess the prognostic impact of malignancy by comparing OH patients to a control group of CS patients.

Results: The 30-day survival rate was 44.8 %. Multivariate analysis identified previous cardiomyopathy (OR = 1.61), acute kidney injury (OR = 1.62), lactate levels (OR = 1.08 per 1 mmol/L), pulmonary embolism (OR = 3.04), invasive mechanical ventilation (OR = 3.48), and epinephrine use (OR = 2.09) as factors associated with 30-day mortality. Among ICU survivors, 54 % were alive at 1 year with a median left ventricular ejection fraction of 52 %. OH malignancy was significantly associated with 30-day mortality (HR 2.54).

Conclusion: The prognosis for OH patients with CS in the ICU is poor, with epinephrine use associated with worse outcomes. Further research is needed to refine risk stratification and improve treatments for this population.

Keywords: Cardiogenic shock; Onco-hematological malignancy - intensive care.

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Conflict of interest statement

Declaration of competing interest LZ reports receiving fees for lectures for MSD and Sanofi, outside of the submitted work. EC has received lecturer and conference-speaker fees, as well as reimbursements of travel and accommodation expenses related to attending scientific meetings, from Gilead, Shionogi, and Sanofi-Genzyme. SP received a mobility research grant from Institut Servier, outside of the submitted work. Other authors declare no conflict of interest (ML, HK, OI, JHR, FB, NI, MD, ASM, FT, BM, LC, NM, GL, FW, HW, HM, LA, AK, GD).

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