Gender differences in patients with cardiogenic shock complicating myocardial infarction: a substudy of the IABP-SHOCK II-trial

Fengler, Karl; Fuernau, Georg; Desch, Steffen; Eitel, Ingo; Neumann, Franz‐Josef; Olbrich, Hans-Georg; Waha, Antoinette de; Waha, Suzanne de; Richardt, Gert; Hennersdorf, Marcus; Empen, Klaus; Hambrecht, Rainer; Fuhrmann, Jörg; Böhm, Michael; Poess, Janine; Strasser, Ruth H.; Schneider, Steffen; Schuler, Gerhard; Werdan, Karl; Zeymer, Uwe; Thiele, Holger

doi:10.1007/s00392-014-0767-2

Cited by 74 publications

(33 citation statements)

References 27 publications

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“…Consistent with our cohort, previous studies have also found women presenting with CS to be significantly older than men [ 12 , 16 , 17 , 18 , 19 , 22 ], however, the mean age of both groups in our study (76 years in women and 70.8 in men) were much higher than those already reported. Collado-Lledó et al reported mean ages of 67 and 64 years old for women and men, respectively [ 22 ].…”

Section: Discussionsupporting

confidence: 92%

“…Compared to men, women with AMI have a higher unadjusted mortality rate and lower use of guideline-recommended therapies, such as early intervention, reperfusion therapy, administration of thienopyridines, and glycoprotein inhibitors [ 13 , 14 , 15 ]. Moreover, gender-related management disparities have also been reported in the context of chronic heart failure [ 16 , 17 , 18 ] and cardiogenic shock [ 10 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to most previously published series [ 10 , 12 , 19 , 20 , 21 , 22 , 23 , 24 ], we collected both AMI and non-AMI-related episodes of CS. STEMI and NSTEMI represented the main causes, accounting for more than 50% of the cases of CS in both groups.…”

Section: Discussionmentioning

confidence: 99%

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Cardiogenic Shock Clinical Presentation, Management, and In-Hospital Outcomes in Patients Admitted to the Acute Cardiac Care Unit of a Tertiary Hospital: Does Gender Play a Role?

Jerónimo

Ferrández‐Escarabajal

Ferrera

et al. 2020

JCM

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Cardiogenic shock (CS), as the most severe form of heart failure, is associated with very high mortality rates despite therapeutic advances in the last decades. Gender differences in outcomes have been widely reported regarding several cardiovascular diseases. The aim of our study was to evaluate potential gender disparities in clinical presentation, management, and in-hospital outcomes of all (n = 138) patients admitted to the Acute Cardiac Care Unit of a tertiary hospital from 2013 to 2019. Information on demographic characteristics, past medical history, haemodynamic and clinical status at admission, therapeutic management, and in-hospital outcomes was retrospectively collected. Women represented 31.88% of the cohort, were significantly older than the men and had a lower proportion of smokers, chronic obstructive pulmonary disease, and previous acute myocardial infarction (AMI). Most CSs in both groups were AMI-related. Left ventricular ejection fraction at admission was higher in women, who were less likely to receive vasopressors. No differences were observed regarding mechanical circulatory support use and in-patient outcomes, with age being the only factor associated with in-hospital mortality on multivariate analysis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Cardiogenic Shock Clinical Presentation, Management, and In-Hospital Outcomes in Patients Admitted to the Acute Cardiac Care Unit of a Tertiary Hospital: Does Gender Play a Role?

Jerónimo

Ferrández‐Escarabajal

Ferrera

et al. 2020

JCM

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“…The few randomized trials [ 3 , 14 , 15 ] addressing patients with CS showed negative results, and literature is mostly base in heterogeneous observational studies addressing ACS-related CS [ 16 – 21 ]. The proportion of women in these series ranges between 25 and 45%, with mean ages ranging between 65 and 80 years [ 16 – 22 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical picture, management and risk stratification in patients with cardiogenic shock: does gender matter?

Collado-Lledó

Llaó

Rivas‐Lasarte

et al. 2020

BMC Cardiovasc Disord

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Background: Early recognition and risk stratification are crucial in cardiogenic shock (CS). A lower adherence to recommendations has been described in women with cardiovascular diseases. Little information exists about disparities in clinical picture, management and performance of risk stratification tools according to gender in patients with CS. Methods: Data from the multicenter Red-Shock registry were used. All consecutive patients with CS were included. Both CardShock and IABP-SHOCK II risk scores were calculated. The primary end-point was in-hospital mortality. The discriminative ability of both scores according to gender was assessed by binary logistic regression, calculating Receiver operating characteristic (ROC) curves and the corresponding area under the curve (AUC). Results: A total of 793 patients were included, of whom 222 (28%) were female. Women were significantly older and had a lower proportion of chronic obstructive pulmonary disease and prior myocardial infarction. CS was less often related to acute coronary syndromes (ACS) in women. The use of vasoactive drugs, renal replacement therapy, invasive ventilation, therapeutic hypothermia and mechanical circulatory support was similar between both groups. In-hospital mortality was 346/793 (43.6%). Mortality was not significantly different according to gender (p = 0.194). Cardshock risk score showed a good ability for predicting in-hospital mortality both in man (AUC 0.69) and women (AUC 0.735). Likewise, the IABP-II successfully predicted in-hospital mortality in both groups (man: AUC 0.693; women: AUC 0.722). Conclusions: No significant differences were observed regarding management and in-hospital mortality according to gender. Both the CardShock and IABP-II risk scores depicted a good ability for predicting mortality also in women with CS.

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“…6 In the setting of CS, women have been shown to have a higher risk-factor profile and are less likely to be treated with intra-aortic balloon pump. 7,8 Despite the high prevalence of CS complicating AMI in women, there is a paucity of sex-specific safety, effectiveness, and outcomes data for mechanical support in the setting of CS, particularly prior to FDA approval. 9 The results of the USpella Registry, including results in patients with a confirmed AMI complicated by CS who underwent percutaneous coronary intervention (PCI) and were supported by an Impella 2.5 device (Abiomed, Danvers), have been previously published.…”

Section: Introductionmentioning

confidence: 99%

Women With Cardiogenic Shock Derive Greater Benefit From Early Mechanical Circulatory Support: An Update From the cVAD Registry

Joseph

Brisco

Colvin

et al. 2016

J Interven Cardiology

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Gender differences in patients with cardiogenic shock complicating myocardial infarction: a substudy of the IABP-SHOCK II-trial

Abstract: In this large-scale multicenter study in patients with CS complicating AMI, women had a worse-risk profile in comparison to men. No significant gender-related differences in treatment as well as short- and long-term outcome were observed.

Cited by 74 publications

References 27 publications

Cardiogenic Shock Clinical Presentation, Management, and In-Hospital Outcomes in Patients Admitted to the Acute Cardiac Care Unit of a Tertiary Hospital: Does Gender Play a Role?

Cardiogenic Shock Clinical Presentation, Management, and In-Hospital Outcomes in Patients Admitted to the Acute Cardiac Care Unit of a Tertiary Hospital: Does Gender Play a Role?

Clinical picture, management and risk stratification in patients with cardiogenic shock: does gender matter?

Women With Cardiogenic Shock Derive Greater Benefit From Early Mechanical Circulatory Support: An Update From the cVAD Registry

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