Takagi K, Blet A, Levy B, et al. - In this ancillary study of a prospective, double-blind, multicentre, randomized study (OptimaCC), researchers examined a cohort of cardiogenic shock (CS) to determine the link between circulating dipeptidyl peptidase 3 (DPP3) (cDPP3) and worsening haemodynamics, namely refractory shock. In OptimaCC, efficacy and safety of catecholamines were evaluated in 57 patients with CS post-acute myocardial infarction. At inclusion, 24 h, 48 h, and 72 h, plasma cDPP3 was measured. At inclusion, haemodynamic and biological parameters were also measured. According to the findings, the early prediction of outcome, including development of refractory status and/or survival, in CS patients was enabled by cDPP3. A higher Simplified Acute Physiology Score II, lower cardiac index and lower estimated glomerular filtration rate was observed in the high cDPP3 group (cDPP3 ≥ 59.1 ng/mL) at inclusion. Among CS patients with high cDPP3 at inclusion, a striking decrease in the occurrence of refractory shock and death was evident in those who rapidly decreased cDPP3 at 24 h.