Hemodynamics, fluids & transfusion
An index of the initial blood pressure response to angiotensin II treatment and its association with clinical outcomes in vasodilatory shock
Authors' conclusion
Among patients with catecholamine-refractory vasodilatory shock treated with angiotensin-II, the AIMRITE was associated with mortality at day-28. Responsive angiotensin-II patients had higher survival versus both angiotensin-II resistant patients and those treated with placebo plus standard vasopressors.
Study context
- Population
- Patients with catecholamine-refractory vasodilatory shock in the ATHOS-3 trial
- Participants
- 97 / 66 / 158
- Comparison
- Responsive vs Resistant vs Placebo
- Responsiven = 97
- Resistantn = 66reference
- Placebon = 158
- Primary endpoint
- Mortality
- Follow-up
- 28 days
Primary result
As reported in the abstract
28-day mortality
Estimate (95% CI)P value
AIMRITE (per 1.0-unit increase)16% lower hazard of death
HR 0.84 per-mmHg/ng/kg/min(0.74–0.95)
P = 0.0062Responsive vs Resistant
HR 0.50(0.32–0.78)
P = 0.0026Responsive vs Placebo
HR 0.58(0.40–0.86)
P = 0.0064Resistant vs Placebo
HR 1.17(0.80–1.72)
P = 0.41Secondary outcomes
| Outcome | Responsive | Resistant | Placebo |
|---|---|---|---|
| AIMRITE distribution (mmHg/ng/kg/min) · hr1Median | 2.55 (IQR 1.66–4.12) | 0.24 (IQR 0.10–0.52) | 0.02 (IQR - 0.03-0.10) |
| AIMRITE < 0.90 mmHg/ng/kg/min | — not stated in the abstract | — not stated in the abstract | 157 (99%) |
| Proportion of angiotensin-II | 60% | 40% | — not stated in the abstract |
— not stated in the abstract
- AIMRITE distribution (mmHg/ng/kg/min): Angiotensin-II median 1.43 (IQR 0.35–2.83) mmHg/ng/kg/min
- AIMRITE distribution (mmHg/ng/kg/min): responsive defined as AIMRITE ≥ 0.90 mmHg/ng/kg/min
- 28-day mortality stratified by baseline renin (subgroup): Placebo, high renin 69%
- 28-day mortality stratified by baseline renin (subgroup): Resistant, low renin 61%
Baseline renin and renin/angiotensin-II ratio, and change at hr3
- Responsive vs resistant: lower baseline renin and renin/angiotensin-II ratio, but greater decrease in both at hr3
28-day mortality stratified by baseline renin (subgroup)
- Mortality highest in placebo patients with high renin and angiotensin-II resistant patients with low renin
Original publication
An index of the initial blood pressure response to angiotensin II treatment and its association with clinical outcomes in vasodilatory shock. Crit Care. Published 19 February 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →