Key result
Female sex shows similar 12-month POCE risk to males after PCI for AMI with cardiogenic shock.
Why the study?
Sex disparities in cardiogenic shock treatment are controversial, and the prognostic implications of sex remain unclear in cardiogenic shock caused by acute myocardial infarction.
Does female sex influence the risk of 12-month POCE in patients treated with PCI for AMI complicated by cardiogenic shock?
Observational (n=695)
Yes
Does female sex influence the risk of 12-month POCE in patients treated with PCI for AMI complicated by cardiogenic shock?
Effect estimate: HR 1.01 (95% CI 0.67-1.53)
p-value: p=0.963
Sex does not appear to influence the 12-month risk of adverse clinical outcomes in patients undergoing PCI for AMI complicated by cardiogenic shock, regardless of shock severity.
No sex difference in 12-month POCE after PCI for AMI cardiogenic shock; hypothesis-generating and should not change practice pending randomized data.
BACKGROUND: Sex disparities in cardiogenic shock (CS) treatment are controversial, and the prognostic implications of sex remain unclear in CS caused by acute myocardial infarction (AMI). OBJECTIVES: This study aimed to evaluate the prognostic effect of sex according to the severity of CS in patients undergoing percutaneous coronary intervention (PCI) for AMI complicated by CS. METHODS: We assessed 695 patients from 12 tertiary centers in South Korea who underwent PCI for AMI complicated by CS, and analyzed outcomes by sex (female [n = 184] vs. male [n = 511]). We compared a 12-month patient-oriented composite endpoint (POCE, defined as a composite of all-cause mortality, myocardial infarction, re-hospitalization due to heart failure, and repeat revascularization) between the sexes, respective of SCAI shock stage C&D or E. Propensity score-matched analysis was performed to reduce bias. RESULTS: We found that the female group was older and had higher vasoactive-inotropic and IABP-SHOCK II scores than the male group, with findings consistent across SCAI shock stages. During the 12-month follow-up period, multivariate analysis revealed no significant differences in POCE (HR 1.01, 95% CI 0.67-1.53, p = 0.963 for SCAI stage C&D, HR 1.24, 95% CI 0.84-1.84, p = 0.286 for SCAI stage E) between females and males. After propensity score matching, the incidence of POCE (HR 1.47, 95% CI 0.79-2.72, p = 0.220 for SCAI stage C&D, HR 0.88, 95% CI 0.49-1.57, p = 0.665 for SCAI stage E) was similar between sexes. CONCLUSIONS: Sex does not appear to influence the risk of 12-month POCE in patients treated with PCI for CS caused by AMI, irrespective of shock severity. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT02985008. RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock), NCT02985008, Registered December 5, 2016 - retrospectively and prospectively. IRB INFORMATION: This study was approved by the institutional review board of Samsung Medical Center (Reference number: 2016-03-130).
No takes yet. Share an insight, caveat, or question.
Kim et al. (2023) conducted an observational in Acute myocardial infarction complicated by cardiogenic shock (n=695). Female sex vs. Male sex was evaluated on 12-month patient-oriented composite endpoint (POCE: all-cause mortality, myocardial infarction, re-hospitalization due to heart failure, and repeat revascularization) (HR 1.01, 95% CI 0.67-1.53, p=0.963). Female sex was not associated with a significantly different risk of 12-month POCE compared to male sex in patients undergoing PCI for AMI with cardiogenic shock (SCAI stage C&D HR 1.01, P=0.963).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: