Milrinone versus dobutamine in the treatment of cardiogenic shock

August 4, 2021

Results of the trial are published in the New England Journal of Medicine

Researchers at the University of Ottawa Heart Institute (UOHI) comparing the efficacy and safety of two inotropic medicines used to treat patients with cardiogenic shock conclude there is no clinically significant difference between either strategy. Cardiogenic shock continues to have a very high mortality rate for cardiac patients with nearly one in two patients dying when presenting with this condition. Results of the Dobutamine compared to Milrinone (DOREMI) trial are published in the New England Journal of Medicine.

“In this randomized controlled trial of milrinone versus dobutamine in patients with cardiogenic shock, milrinone was not superior to dobutamine,” writes Dr. Benjamin Hibbert, an interventional cardiologist and director of the Vascular Biology and Experimental Medicine Laboratory at the UOHI, and principal investigator leading the DOREMI trial. “The selection of either inotrope could reasonably be based on physician comfort, cost, and response to therapy.

Cardiogenic shock occurs when the heart can't pump enough blood to meet the body's needs. Inotropic medicines are a mainstay therapy in the treatment of patients who develop this condition, despite little evidence to guide the selection of such inotropes. The DOREMI trial, which recruited 192 patients in total, is significant because it is one of only four randomized trials of cardiogenic shock to enrol more than 100 patients, and one of only two trials to compare milrinone to dobutamine. These findings will help design future studies to improve outcomes in this high-risk patient population and will inform physicians caring for these patients.

To learn more, or to coordinate an interview with Dr. Benjamin Hibbert, please contact the liaison below.

Media contact:

Sitraka Raoelimanohisoa
Coordinator, Communications
University of Ottawa Heart Institute