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).
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?
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.
Effect estimate: HR 1.01 (95% CI 0.67-1.53)
p-value: p=0.963
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).
Kim et al. (Sun,) conducted a 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).