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Impact of Female Sex on Cardiogenic Shock Outcomes A Cardiogenic Shock Working Group Report
被引:20
作者:
Ton, Van-Khue
[1
]
Kanwar, Manreet K.
[2
]
Li, Borui
[3
]
Blumer, Vanessa
[4
]
Li, Song
[5
]
Zweck, Elric
[6
,7
]
Sinha, Shashank S.
[8
]
Farr, Maryjane
[9
]
Hall, Shelley
[10
]
Kataria, Rachna
[11
]
Guglin, Maya
[12
]
Vorovich, Esther
[13
]
Hernandez-Montfort, Jaime
[14
]
Garan, A. Reshad
[15
]
Pahuja, Mohit
[16
]
Vallabhajosyula, Saraschandra
[17
]
Nathan, Sandeep
[18
]
Abraham, Jacob
[19
]
Harwani, Neil M.
[3
]
Hickey, Gavin W.
[20
]
Wencker, Detlef
[14
]
Schwartzman, Andrew D.
[21
]
Khalife, Wissam
[22
]
Mahr, Claudius
Kim, Ju H.
[23
]
Bhimaraj, Arvind
[23
]
Sangal, Paavni
[3
]
Zhang, Yijing
[3
]
Walec, Karol D.
[3
]
Zazzali, Peter
[3
]
Burkhoff, Daniel
[24
]
Kapur, Navin K.
[3
]
机构:
[1] Massachusetts Gen Hosp, Corrigan Minehan Heart Ctr, Boston, MA USA
[2] Allegheny Hlth Network, Cardiovasc Inst, Pittsburgh, PA USA
[3] Tufts Med Ctr, Cardiovasc Ctr, 800 Washington St, Boston, MA 02111 USA
[4] Cleveland Clin Fdn, Cleveland Hts, OH USA
[5] Univ Washington, Med Ctr, Seattle, WA USA
[6] Heinrich Heine Univ Dusseldorf, Dept Cardiol Pulmonol & Vasc Med, Med Fac, Dusseldorf, Germany
[7] Heinrich Heine Univ Dusseldorf, Univ Hosp Dusseldorf, Dusseldorf, Germany
[8] INOVA Heart & Vasc Inst, INOVA Fairfax Med Campus, Falls Church, VA USA
[9] Univ Texas Southwestern Med Ctr, Dallas, TX USA
[10] Baylor Univ, Med Ctr, Dallas, TX USA
[11] Brown Univ, Lifespan Cardiovasc Ctr, Providence, RI 02903 USA
[12] Indiana Univ Sch Med, Krannert Inst Cardiol, Indianapolis, IN USA
[13] Northwestern Univ, Bluhm Cardiovasc Inst, Chicago, IL 60611 USA
[14] Baylor Scott & White Hlth, Temple, TX USA
[15] Beth Israel Deaconess Med Ctr, Boston, MA USA
[16] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA
[17] Wake Forest Sch Med, Winston Salem, NC USA
[18] Univ Chicago, Chicago, IL USA
[19] Providence Heart Inst, Portland, OR USA
[20] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA
[21] Maine Med Ctr, Portland, ME USA
[22] Univ Texas Med Branch, Galveston, TX USA
[23] Houston Methodist Res Inst, Houston, TX USA
[24] Cardiovasc Res Fdn, New York, NY USA
关键词:
cardiogenic shock;
heart failure;
women;
MANAGEMENT;
SUPPORT;
CARE;
D O I:
10.1016/j.jchf.2023.09.025
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
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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页码:1742 / 1753
页数:12
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