D-10 | Racial and Gender Disparities in patients with Cardiogenic Shock complicating Acute Myocardial Infarction

Cardiogenic shock (CS) remains a major cause of mortality in patients who present with ST-elevation myocardial infarction (STEMI) and the use of mechanical circulatory devices are being increasingly used for hemodynamic support. Racial and gender disparities in this subset of patients have not been well studied in contemporary practice. We performed a secondary data analysis using data from the National Inpatient Sample (NIS) from 2016-2018. We identified patients with a diagnosis of Cardiogenic Shock and Acute Myocardial Infarction using the International Classification of Diseases - ICD 10 codes. The primary outcome evaluated was in-hospital mortality. Continuous variables are presented as means with standard deviation and categorical variables as percentages. For categorical variables, group differences were analyzed using chi-square, and differences for continuous variables were measured with the student's T-test. A total of 10701 (66%) male and 5509 (34%) female patients were identified with CS and STEMI. In-hospital mortality was higher for all women (40%) compared with men (34%) which was found to be statistically significant (p <0.0001). Intra-aortic balloon pump (IABP) was used more in men (34%) compared to women (27%), p <0.0001. A total of 11337 (74%) of CS-AMI patients were White. In-hospital mortality was higher for Black patients, 39%, compared to White patients, 35%, (p = 0.003). IABP was utilized more than Impella among all the races and was statistically significant (p = 0.001) There are statistically significant gender and racial differences in mortality for patients presenting with AMI complicated by cardiogenic shock. Women are less likely to have mechanical circulatory device support and have a higher likelihood of death compared to men. Physicians must be cognizant of these disparities and work to improve outcomes for women and minorities.