This systematic review compared corticosteroids with placebo or usual care in adults with cardiogenic shock. Eight studies were included, but the primary analysis comprised three observational studies of clearly defined cardiogenic shock. Unadjusted acute mortality showed no clear effect (risk ratio 1.05, 95% confidence interval 0.98–1.13), with high residual-confounding risk and very low evidence certainty. Weak evidence suggested increased hyperglycaemia and hospital-acquired infection, but definitions varied and certainty was very low. The authors concluded that evidence was insufficient to determine corticosteroids’ effect on acute mortality.
The available evidence does not establish whether corticosteroids affect acute mortality in cardiogenic shock. Potential adverse-outcome signals also remain highly uncertain.
Study limitation: The primary analysis relied on three observational studies, with substantial clinical heterogeneity and high risk of residual confounding.
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