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Sex-Based Survival Outcomes in Cardiogenic Shock. | LitMetric

AI Article Synopsis

  • A study analyzed 1,498 patients with cardiogenic shock (CS) from a cardiovascular intensive care unit over 11 years, focusing on sex-based differences in care and outcomes.
  • The findings showed that while there were no significant differences in overall mortality rates between males and females, women were less likely to receive temporary mechanical circulatory support compared to men, particularly in cases without acute myocardial infarction.
  • Importantly, females who underwent percutaneous intervention had lower 1-year mortality rates, suggesting that the underutilization of this treatment in women may be detrimental to their outcomes.

Article Abstract

Background: Sex-based disparities have been demonstrated in care delivery for females with cardiogenic shock (CS), including lower use of coronary angiography (CAG), percutaneous intervention (PCI) and mechanical circulatory support (MCS). We evaluated whether sex-based disparities exist and are associated with worse CS outcomes in females.

Methods: We studied a retrospective cohort of 1498 consecutive, unique adult cardiovascular intensive care unit (CICU) admissions with CS from 2007-2018.

Results: Compared to males, females (n = 566, 37.1%) were older (71.7 vs 67.8 years; P < 0.001) but had similar burdens of medical comorbidities. Acute myocardial infarction (AMI) was present in 54.1% of females and 59.1% of males (P = 0.06). There were no sex-based differences in the use of CAG and PCI, but females received temporary MCS less commonly. Specifically, females with non-AMI CS received MCS devices less commonly (17.6% vs 24.4%; P = 0.04). There was no difference in in-hospital or 1-year mortality rates between the sexes. Compared to males, females who received PCI had lower risks of 1-year mortality (unadjusted HR 0.72; P = 0.03), whereas females who received CAG without PCI had higher risks of 1-year mortality (unadjusted HR 1.41; P = 0.02).

Conclusions: No sex-based disparities in mortality due to CS were demonstrated in this large, diverse cohort of patients with CICU admissions. Females who underwent PCI demonstrated lower risks of 1-year mortality, whereas females who underwent CAG without PCI demonstrated higher risks of 1-year mortality compared to males. This may reflect underuse of PCI as a mortality-reducing therapy in females.

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Source
http://dx.doi.org/10.1016/j.cardfail.2024.06.016DOI Listing

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