(422) Changes in Pulse Pressure after 24 Hours of Initiation of Inotrope Therapy in Cardiogenic Shock is Associated with Adverse Outcomes

PurposeCardiogenic shock (CS) is a leading cause of in-hospital morbidity and mortality. We sought to determine the association between serial changes in hemodynamics after initiation inotrope therapy outcomes.MethodsData were obtained from DOREMI randomized clinical trial. A total 155 participants with SCAI Stage C CS at single center 9/2017 5/2020 included. Participants received either dobutamine or milrinone for CS. Serial measurements pulse pressure percent change baseline measured 4, 12, 24 hours inotropes. The primary outcome was composite death, resuscitated cardiac arrest, transplant mechanical support, non-fatal myocardial infarction, cerebrovascular event renal replacement therapy. secondary death.ResultsThe cohort predominantly male (62.6%), mean age 70.6±12.5 years. 77 (49.7%) milrinone, remaining dobutamine. At baseline, patients stage had median 45 (IQR: [34, 56]) mmHg. Lower absolute associated (median 2 IQR: [-4, 10] vs. 9 IQR 20] mmHg, p=0.03) (p=0.027). who met reduced compared 4.3% [-7.7%, 23.8%] 16.5% [-9.6%, 52.9%], p=0.05). Pulse alone each time point not (0 hours: p=0.46, 4 p=0.85, 12 p=0.89, p=0.10).ConclusionIn CS, an adverse cardiovascular outcomes. This dynamic may be considered decisions regarding early escalation Cardiogenic Data death. p=0.10). In