Cardiogenic shock and infection: A lethal combination

[Display omitted] •Sepsis triggers are frequent, concerning almost 12% of unselected CS cases.•Sepsis trigger can be exclusive (2/3 cases) or associated with other CS triggers.•The other triggers are ischaemia, arrythmias or iatrogenesis.•Sepsis-triggered CS was more profound, with more severe organ dysfunction.•Sepsis-triggered CS required more use of vasopressors/inotropes and organ support.•Sepsis-triggered CS was associated with higher short- and long-term death rates. Cardiogenic shock and sepsis are severe haemodynamic states that are frequently present concomitantly, leading to substantial mortality. Despite its frequency and clinical significance, there is a striking lack of literature on the outcomes of combined sepsis and cardiogenic shock. FRENSHOCK was a prospective registry including 772 patients with cardiogenic shock from 49 centres. The primary endpoint was 1-month all-cause mortality. Secondary endpoints included heart transplantation, ventricular assistance device and all-cause death rate at 1year. Among the 772 patients with cardiogenic shock included, 92 cases were triggered by sepsis (11.9%), displaying more frequent renal and hepatic acute injuries, with lower mean arterial pressure. Patients in the sepsis group required broader use of dobutamine (90.1% vs. 81.2%; P=0.16), norepinephrine (72.5% vs. 50.8%; P