Con: Cardiac Arrest Patients Should Be Included in Cardiogenic Shock Trials

While often being both triggered by acute myocardial infarction, cardiogenic shock (CS) and cardiac arrest (CA) constitute two distinct clinical entities with different underlying pathophysiologic backgrounds. CS is a syndrome characterized by systemic hypoperfusion and end-organ dysfunction due to a primary impairment of the cardiac pump function. CA arises instead from an abrupt loss of cardiac mechanical function—commonly triggered by arrhythmias, structural heart disease, or ischemic events—which leads to the immediate loss of effective circulation. Their diverse sequelae and factors that contribute to patient mortality (i.e., anoxic brain injury for CA and cardiac failure for CS) call for the need to analyze these populations separately in clinical trials.