Clinical and biological factors associated with 28-day mortality included older age, high SAPS II score, past medical history of arterial hypertension or chronic systolic heart failure, chronic use of some cardiovascular medications (aspirin, statin, diuretics, angiotensin-converting enzyme inhibitor, or angiotensin receptor blockers), high SOFA score and high doses of norepinephrine at time of echocardiography, lactic acidosis, and increased serum creatinine, hs-TNT, and CPK (Table 1). Here, ACE is linked to lactic acidosis.