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Updated: Apr 23, 2026
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Gender differences in patients with cardiogenic shock complicating myocardial infarction: a substudy of the
Karl Fengler1, Georg Fuernau, Steffen Desch
1Department of Internal Medicine, Cardiology, University of Leipzig, Heart Center, Strümpellstraße 39, 04289, Leipzig, Germany.
Insights
In cardiogenic shock (CS) complicating acute myocardial infarction (AMI), women presented with a higher-risk profile. However, no significant gender differences in treatment or outcomes were found in this contemporary study.
Area of Science:
- Cardiology
- Clinical Research
- Gender Medicine
Background:
- Cardiogenic shock (CS) following acute myocardial infarction (AMI) carries a high mortality rate.
- Existing research on gender-specific differences in CS is conflicting, with limited data from the current percutaneous coronary intervention era.
- This study addresses the need for contemporary data on gender disparities in CS management and outcomes.
Purpose of the Study:
- To investigate gender-specific differences in a large cohort of patients with AMI and CS.
- To analyze baseline characteristics, procedural factors, and clinical outcomes based on sex.
- To evaluate outcomes in the context of modern treatment strategies.
Main Methods:
- Analysis of data from the randomized Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial.
- Inclusion of 600 patients with CS complicating AMI undergoing early revascularization.
- Comparison of sex-specific differences in baseline characteristics, procedural data, and short- and long-term clinical outcomes.
Main Results:
- Women comprised 31% of the study population and were older with lower blood pressure on presentation.
- Higher prevalence of diabetes and hypertension in women, while men had higher rates of smoking.
- Initial higher mortality in women within the first day was not statistically significant after multivariable adjustment; no significant gender differences in outcomes at 1, 6, or 12 months.
Conclusions:
- Women with CS complicating AMI exhibited a worse-risk profile compared to men.
- Despite baseline differences, no significant gender-related disparities in treatment or short- and long-term clinical outcomes were observed.
- Findings highlight the importance of considering gender in risk stratification while emphasizing similar treatment efficacy.
Background:
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.
Methods:
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.
Results:
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.
Conclusion:
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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