Female sex was associated with similar mortality compared to male sex in AMI-related cardiogenic shock, despite a trend toward less mechanical circulatory support use (OR 0.86; 95% CI 0.67-1.09).
Cohort (n=2,274)
Yes
Are there sex-specific differences in presentation, treatment, and outcomes among patients with AMI-related cardiogenic shock undergoing PCI?
Despite women presenting at an older age and with longer symptom duration, mortality in AMI-related cardiogenic shock is similar between men and women.
BACKGROUND: Women are underrepresented In cardiovascular disease research, constituting only 30 % of the cardiogenic shock (CS) population. Consequently, guidelines are mainly based on male patients. This study aims to comprehensively examine the sex-specific aspects of acute myocardial infarction (AMI)-related CS, encompassing presentation, treatment and outcomes. METHODS: Patients with CS undergoing percutaneous coronary intervention (PCI) between 2017 and 2021 were identified using the national Netherlands Heart Registration. Mortality was assessed using the Kaplan Meier method, and logistic regression was performed to investigate differences in clinical management between sexes. Furthermore, a sensitivity analysis excluding patients with out-of-hospital cardiac arrest (OHCA) was conducted. RESULTS: Among 2274 patients, 614 (27 %) were female. Women were older (70 vs. 66 years, p 3 h: 52 % vs. 37 %, p < 0.001). Men more often presented with multivessel disease (62 % vs. 56 %, p < 0.001), a prior myocardial infarction (23 % vs. 15 %, p < 0.001) and after an OHCA (46 % vs. 29 %, p < 0.001). A trend towards more usage of mechanical circulatory support in men was observed (adjusted OR 0.86, 95 % CI 0.67-1.09). Mortality, both adjusted and unadjusted, was not statistically different for men and women. CONCLUSION: Women with CS present with distinct clinical characteristics, including longer symptom duration, underscoring the importance of symptom recognition. Furthermore, men present at younger age and with more OHCA. Mortality in men and women was similar despite differences in presentation and clinical management.
Peters et al. (Thu,) conducted a cohort in Acute myocardial infarction (AMI)-related cardiogenic shock (n=2,274). Female sex vs. Male sex was evaluated on Mortality. Female sex was associated with similar mortality compared to male sex in AMI-related cardiogenic shock, despite a trend toward less mechanical circulatory support use (OR 0.86; 95% CI 0.67-1.09).