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. 2025 Jul 9:25:101024.
doi: 10.1016/j.resplu.2025.101024. eCollection 2025 Sep.

Comparative features and outcomes of cardiogenic shock in patients with and without prior resuscitated shockable cardiac arrest: Insight from the FRENSHOCK multicenter prospective registry

Hamid Merdji  1 , Vincent Bataille  2   3 , Anais Curtiaud  1 , Laurent Bonello  4   5   6 , François Roubille  7 , Bruno Levy  8 , Pascal Lim  9   10 , Jean-Claude Dib  11 , Julien Maizel  12 , Nicolas Brechot  13 , Marion Beuzelin  14 , Emmanuelle Fillippi  15 , Miloud Cherbi  16   17 , Julien Demiselle  1 , Grégoire Rangé  18 , Jérémie Joffre  19 , Marwan Yassine  20 , Caroline Biendel  16   17 , Fanny Bounes  21 , Guillaume Leurent  22 , Edouard Gerbaud  23   24 , Eric Bonnefoy  25 , Etienne Puymirat  26 , Clément Delmas  16   17   27 ; FRENSHOCK Investigators
Collaborators, Affiliations

Comparative features and outcomes of cardiogenic shock in patients with and without prior resuscitated shockable cardiac arrest: Insight from the FRENSHOCK multicenter prospective registry

Hamid Merdji et al. Resusc Plus. .

Abstract

Aim: Differences between cardiogenic shock (CS) with and without prior resuscitated cardiac arrest (CA) remain largely unexplored. We hypothesized that patients who experience shockable CA followed by CS are likely to have worse outcomes compared to CS without prior CA.

Methods: FRENSHOCK is a prospective multicenter observational registry conducted in French critical care units in 2016, which included CS from various etiologies. Patients admitted after resuscitation of a CA were included if they fulfilled previously defined CS criteria. Non-shockable rhythms at the time of medical intervention were considered exclusion criteria and were not recorded in the registry.

Results: Among the 771 enrolled patients (mean age 65.7 ± 14.9 years; 71.5 % male), 79 (10.2 %) had a resuscitated shockable cardiac arrest just before inclusion. Shockable CA patients had more respiratory support (78.5 % vs. 33.2 %, p < 0.001), more mechanical circulatory support (35.4 % vs. 16.5 %, p < 0.001), more coronary angiography performed (76 % vs. 48.8 %, p < 0.001), finding more mono-troncular lesions (39 % vs. 16.9 %, p < 0.001). Thirty-day and one-year survival were similar between groups. Among 30-day survivors, CS with an initial shockable CA exhibited significantly improved long-term survival compared to CS without prior resuscitated CA.

Conclusion: In a cohort of patients with cardiogenic shock from various etiologies, approximately 10% had experienced prior resuscitation following a cardiac arrest with shockable rhythms. Our findings suggest that selected cardiac arrest with a shockable rhythm leading to cardiogenic shock does not inherently confer a worse prognosis compared to other causes of cardiogenic shock.

Keywords: Cardiac arrest; Cardiogenic shock; Heart failure; Post-cardiac arrest syndrome.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Early (30-day) mortality in patients with and without prior resuscitated shockable CA before the onset of CS. Kaplan-Meier Landmark analysis of failure rate (all-cause death) of 30-day survivors. CA-CS: CS following resuscitated shockable CA. No CA-CS: CS without prior resuscitated CA.
Fig. 2
Fig. 2
Long-term (1-year) mortality in patients with and without prior resuscitated shockable CA before the onset of CS CA-CS: CS following resuscitated shockable CA. No CA-CS: CS without prior resuscitated CA.
Fig. 3
Fig. 3
Kaplan-Meier Landmark analysis of failure rate (all-cause death) of 30-day survivors in patients with and without prior resuscitated shockable CA before the onset of CS. Kaplan-Meier Landmark analysis of failure rate (all-cause death) among 30-day survivors. CA-CS: CS following resuscitated shockable CA. No CA-CS: CS without prior resuscitated CA.
See this image and copyright information in PMC

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