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Impact of Female Sex on Cardiogenic Shock Outcomes A Cardiogenic Shock Working Group Report
Journal article   Peer reviewed

Impact of Female Sex on Cardiogenic Shock Outcomes A Cardiogenic Shock Working Group Report

Van-Khue Ton, Manreet K. Kanwar, Borui Li, Vanessa Blumer, Song Li, Elric Zweck, Shashank S. Sinha, Maryjane Farr, Shelley Hall, Rachna Kataria, …
JACC. Heart failure, v 11(12), pp 1742-1753
01 Dec 2023
DOI: https://doi.org/10.1016/j.jchf.2023.09.025
PMID: 37930289
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.jchf.2023.09.025View
Published, Version of Record (VoR)Open Access (Publisher-Specific),  Restricted

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology
BACKGROUND Studies reporting cardiogenic shock (CS) outcomes in women are scarce.OBJECTIVES The authors compared survival at discharge among women vs men with CS complicating acute myocardial infarction (AMI-CS) and heart failure (HF-CS).METHODS The authors analyzed 5,083 CS patients in the Cardiogenic Shock Working Group. Propensity score matching (PSM) was performed with the use of baseline characteristics. Logistic regression was performed for log odds of survival.RESULTS Among 5,083 patients, 1,522 were women (30%), whose mean age was 61.8 +/- 15.8 years. There were 30% women and 29.1% men with AMI-CS (P = 0.03). More women presented with de novo HF-CS compared with men (26.2% vs 19.3%; P < 0.001). Before PSM, differences in baseline characteristics and sex-specific outcomes were seen in the HF-CS cohort, with worse survival at discharge (69.9% vs 74.4%; P = 0.009) and a higher rate of maximum Society for Cardiac Angiography and Interventions stage E (26% vs 21%; P = 0.04) in women than in men. Women were less likely to receive pulmonary artery catheterization (52.9% vs 54.6%; P < 0.001), heart transplantation (6.5% vs 10.3%; P < 0.001), or left ventricular assist device implantation (7.8% vs 10%; P = 0.01). Regardless of CS etiology, women had more vascular complications (8.8% vs 5.7%; P < 0.001), bleeding (7.1% vs 5.2%; P = 0.01), and limb ischemia (6.8% vs 4.5%; P = 0.001). More vascular complications persisted in women after PSM (10.4% women vs 7.4% men; P = 0.06).CONCLUSIONS Women with HF-CS had worse outcomes and more vascular complications than men with HF-CS. More studies are needed to identify barriers to advanced therapies, decrease complications, and improve outcomes of women with CS. (J Am Coll Cardiol HF 2023;11:1742-1753) (c) 2023 Published by Elsevier on behalf of the American College of Cardiology Foundation.

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Cardiac & Cardiovascular Systems
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