Journal of Cardiovascular Pharmacology and Therapeutics · Published 2026-06-01 · DOI 10.1177/10742484261456161
Suthida Chanchenchop, Supanee Sinphurmsukskul, Krittin Bunditanukul
Background Cardiogenic shock remains a life-threatening condition with persistently high mortality. Norepinephrine and dopamine are commonly used vasoactive agents; however, comparative data on clinical outcomes remain limited. Methods This retrospective cohort study included 388 adults with cardiogenic shock treated with norepinephrine ( n = 72) or dopamine ( n = 316) at King Chulalongkorn Memorial Hospital, Thailand. The primary outcome was 28-day mortality. Survival was evaluated using Kaplan–Meier analysis and Cox proportional hazards regression. Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding by indication. Results Mortality at 28 days occurred in 30.6% and 25.9% of the norepinephrine and dopamine groups, respectively. No statistically significant difference in 28-day mortality was observed in either the unadjusted (HR 0.84, 95% CI 0.52-1.34; P = .463) or IPTW-adjusted Cox proportional hazards model (HR 1.10, 95% CI 0.64-1.88; P = .725). Epinephrine rescue rates were comparable between groups (27.7% vs 24.2%; P = .551). Independent predictors of 28-day mortality included age ≥65 years, cardiopulmonary resuscitation, and epinephrine use ( P < .001 for all), as well as renal replacement therapy and endotracheal intubation ( P = .003 for both). Conclusion The present study did not demonstrate a significant difference in 28-day mortality between norepinephrine and dopamine; however, dopamine was associated with a significantly higher incidence of arrhythmias.
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Chanchenchop, S., Sinphurmsukskul, S., Bunditanukul, K. (2026). Norepinephrine Versus Dopamine as Vasoactive Therapy in Cardiogenic Shock: Association With 28-Day Mortality in a Retrospective Cohort Study. Journal of Cardiovascular Pharmacology and Therapeutics. https://doi.org/10.1177/10742484261456161