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

Area of Science:

• Cardiology
• Clinical Medicine
• Health Services Research

Background:

• Early recognition and risk stratification are vital in cardiogenic shock (CS).
• Women with cardiovascular diseases often show lower adherence to treatment recommendations.
• Limited data exists on gender-based disparities in CS clinical presentation, management, and risk stratification tool performance.

Purpose of the Study:

• To investigate potential gender-based differences in the clinical picture, management, and risk stratification tool performance in patients with cardiogenic shock.
• To evaluate the effectiveness of the CardShock and IABP-SHOCK II risk scores in predicting in-hospital mortality in both male and female patients with CS.

Main Methods:

• Utilized data from the multicenter Red-Shock registry, including consecutive patients diagnosed with CS.
• Calculated CardShock and IABP-SHOCK II risk scores for all included patients.
• Assessed the discriminative ability of risk scores by gender using binary logistic regression and Receiver Operating Characteristic (ROC) curves with Area Under the Curve (AUC).

Main Results:

• A total of 793 patients were analyzed (28% female). Women were older and less likely to have COPD or prior MI.
• Cardiogenic shock in women was less frequently associated with acute coronary syndromes (ACS).
• In-hospital mortality was 43.6% and not significantly different between genders (p=0.194). Both CardShock (AUC 0.69/0.735) and IABP-SHOCK II (AUC 0.693/0.722) scores accurately predicted mortality in men and women.

Conclusions:

• No significant gender-based differences were found in the management or in-hospital mortality of cardiogenic shock patients.
• The CardShock and IABP-SHOCK II risk scores demonstrate good predictive ability for mortality in women with cardiogenic shock, similar to men.