Key result
Younger age (45-55 years) was associated with a significantly lower three-year all-cause mortality compared to older age (56-75 years) in women with post-myocardial infarction cardiogenic shock (36.2% vs. 41.2%, HR 0.82).
Why the study?
Does age (45-55 vs 56-75 years) affect outcomes in female patients with post-myocardial infarction cardiogenic shock?
Cohort (n=2,200)
Yes
Does age (45-55 vs 56-75 years) affect outcomes in female patients with post-myocardial infarction cardiogenic shock?
Hazard Ratio: 0.82 (95% CI 0.71–0.91)
Absolute Event Rate: 36.2% vs 41.2%
Absolute Risk Reduction: 5%
p-value: p=0.001
Among women with post-MI cardiogenic shock, older age (56-75 years) is associated with higher mortality and atrial fibrillation risk, whereas younger age (45-55 years) is associated with more frequent emergency readmissions.
Older women with post-MI CS show higher mortality; observational data leaves open whether age-specific strategies warrant prospective trials.
BACKGROUND: Cardiogenic shock (CS) complicating myocardial infarction (MI) is associated with high morbidity and mortality, with age- and sex-specific differences in presentation and outcomes. Female patients, often underrepresented in cardiovascular research, exhibit distinct clinical profiles and treatment patterns. However, age-stratified outcomes among women with post-MI CS remain insufficiently described. AIM: This study aimed to compare the outcomes of post-MI CS between female patients in two distinct age groups: 45-55 and 56-75 years. METHODS: We conducted a retrospective cohort study using the TriNetX Research Network, including deidentified electronic health records from 102 healthcare organizations between January 1, 2017, and January 1, 2023. Female patients aged 45-55 or 56-75 years with both acute MI (International Classification of Diseases, 10th Revision, ICD-10: I21) and CS (ICD-10: R57.0) were identified. Two cohorts were generated and matched 1:1 using propensity scores for demographics and comorbidities, resulting in 1,100 patients per group. Outcomes assessed included all-cause mortality, major adverse cardiac events (MACE), arrhythmias, atrial fibrillation (Afib), cardiac device procedures/complications, and emergency readmissions over a three-year follow-up. Outcomes were compared using Kaplan-Meier analysis and Cox proportional hazards models. RESULTS: Older women (56-75 years) had significantly higher three-year mortality compared to the younger cohort (41.2% vs. 36.2%, p = 0.016), as well as increased incidence of Afib (26.5% vs. 22.7%, p = 0.038). Rates of MACE and other arrhythmias were similar between the groups. Emergency readmissions were more common in younger women (33.7% vs. 29.3%, p = 0.025), while device-related procedures showed low event rates and group-specific trends. Absolute differences in outcomes were modest. CONCLUSIONS: Age-related differences exist among female patients with post-MI CS. Older women face higher mortality and Afib risk, while younger women experience more frequent emergency readmissions. These findings highlight the need for age-specific postdischarge strategies, but must be interpreted cautiously given the study's retrospective design, reliance on administrative coding, and lack of granular clinical data. Further prospective research is needed to elucidate the mechanisms and inform tailored interventions for women with CS following MI.
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Asangmbeng et al. (2025) conducted a cohort in Cardiogenic shock complicating acute myocardial infarction (n=2,200). Age 45-55 years vs. Age 56-75 years was evaluated on All-cause mortality at 3 years (HR 0.82, 95% CI 0.71-0.91, p=0.001). Younger age (45-55 years) was associated with a significantly lower three-year all-cause mortality compared to older age (56-75 years) in women with post-myocardial infarction cardiogenic shock (36.2% vs. 41.2%, HR 0.82).
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