Gender comparisons in cardiogenic shock during ST elevation myocardial infarction treated by primary percutaneous...

Area of Science:

• Cardiology
• Critical Care Medicine
• Interventional Cardiology

Background:

• Cardiogenic shock (CS) is a major cause of death in acute myocardial infarction (AMI) patients.
• Historically, CS mortality rates were high (70-80%), but have decreased with advancements like early revascularization and mechanical support.
• Previous research indicated a higher CS incidence in women post-AMI.

Purpose of the Study:

• To evaluate hospital mortality outcomes in patients with CS undergoing primary percutaneous coronary intervention (PPCI).
• To investigate potential gender differences in mortality among CS patients treated with PPCI.

Main Methods:

• Prospective data collection from April 2008 to October 2011 at a UK tertiary cardiac center.
• Analysis of 2,864 patients undergoing PPCI for AMI, with a focus on the 141 patients diagnosed with CS.
• Comparison of mortality rates and demographic data between male and female CS patients.

Main Results:

• The overall hospital mortality for CS patients undergoing PPCI was 35.5%.
• A higher proportion of women (7.1%) presented with CS compared to men (4.0%) (p <0.001).
• Female CS patients were older on average (69.9 years) than male CS patients (64.2 years), yet hospital mortality showed no significant gender difference (35% vs 35.8%, p >0.99).

Conclusions:

• Contemporary PPCI strategies have led to reduced incidence and improved hospital mortality for CS complicating AMI.
• Remarkably, despite presenting with higher incidence and at an older age, women with CS showed no mortality difference compared to men.
• Further long-term follow-up studies are needed to confirm the sustained absence of gender disparity in CS outcomes.