Table 1.

Summary of major studies of inotropes and vasopressors for treatment of cardiogenic shock

Major studies of inotrope or vasopressor effect on outcome in cardiogenic shock
Study	Year	Interventions and objective	Design	n	Etiology	Findings
De Backer et al. (SOAP II) [30]	2010	Dopamine vs. norepinephrine in any form of shock; subgroup analysis of CS	Multicenter RCT	1679; 280 with CS	Any	Norepinephrine was associated with improved CS survival at 28 days (0.5 vs. 0.4 in Kaplan–Meier analysis, respectively; p = 0.03)
Levy et al. (OptimaCC) [31]	2018	Safety and efficacy of norepinephrine vs. epinephrine	Multicenter RCT	57	AMI-CS	No difference in improvement in cardiac index or mortality to 28 days (p = 0.11). Epinephrine associated with higher incidence of refractory CS (37% vs. 7%, p = 0.011)
Mathew et al. (DOREMI) [24]	2021	Dobutamine vs. milrinone in treatment of CS	Multicenter RCT	192	Any	Composite primary outcome (all cause in hospital mortality, resuscitated cardiac arrest, cardiac transplant, or mechanical circulatory support, nonfatal myocardial infarction, transient ischemic attack, or stroke, or initiation of RRT) occurred in 54% of dobutamine recipients compared to 49% of the milrinone cohort (RR 0.90, 95% CI 0.69–1.19
Delmas et al. (FRENSHOCK) [27]	2022	Registry comparing interventions and outcomes for 30-day CS survivors vs. non-survivors	Multicenter cohort, retrospective review	772	Any; 36.3% with ischemic CS	Multivariate analysis showed that norepinephrine (OR 2.55, 95% CI 1.69–3.84, p < 0.001), was associated with higher 30-day mortality
Pirracchio et al. [32]	2013	Comparison of inopressor alone (norepinephrine, epinephrine, or dopamine) vs. inopressor with inodilator (dobutamine, levosimendan, or phosphodiesterase-3 inhibitors)	Multicenter retrospective propensity-matched cohort	1272	Any	Patients who received inodilator with inopressor had improved 30-day survival (HR 0.61, 95% CI 0.52–0.71, p < 0.05) compared to inopressor alone
Schumann et al. [26]	2018	Review of vasodilators and inotropes	Systematic review/meta-analysis, RCTs	2001	Any	Levosimendan may reduce short-term mortality compared to dobutamine (RR 0.60, 95% CI 0.37–0.95, p < 0.05), but its effect on long-term mortality and its effect compared to placebo is undefined due to lack of statistical power
Karami et al. [28]	2020	Comparative meta-analysis of inotropes and vasopressors	Systematic review/meta-analysis	2478	AMI-CS	Levosimendan trended towards improved mortality up to 90 days, but this was not significant (RR 0.69, 95% CI 0.47–1.00). There were otherwise no differences in mortality between therapies