Journal
CLINICAL RESEARCH IN CARDIOLOGY
Volume 104, Issue 1, Pages 71-78Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00392-014-0767-2
Keywords
Cardiogenic shock; Gender; Sex-differences; Mortality; Myocardial infarction; Early revascularization
Categories
Funding
- German Research Foundation
- German Heart Research Foundation
- German Cardiac Society
- Arbeitsgemeinschaft Leitende Kardiologische Krankenhausarzte
- University of Leipzig-Heart Center
- Maquet Cardiopulmonary
- Teleflex Medical
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Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high mortality. Previous studies regarding gender-specific differences in CS are conflicting and there are insufficient data for the presence of gender-associated differences in the contemporary percutaneous coronary intervention era. Aim of this study was therefore to investigate gender-specific differences in a large cohort of AMI patients with CS undergoing contemporary treatment. In the randomized Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial, 600 patients with CS complicating AMI undergoing early revascularization were assigned to therapy with or without intra-aortic balloon pump. We compared sex-specific differences in these patients with regard to baseline and procedural characteristics as well as short- and long-term clinical outcome. Of 600 patients 187 (31 %) were female. Women were significantly older than men and had a significantly lower systolic and diastolic blood pressure at presentation (p < 0.05 for all). Diabetes mellitus and hypertension were more frequent in women, whereas smoking was more frequent in men (p < 0.05 for all). Women showed a higher mortality within the first day after randomization (p = 0.004). However, after multivariable adjustment this numerical difference was no longer statistically significant. No gender-related differences in clinical outcome were observed after 1, 6 and 12 months of follow-up. 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.
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