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Published on: June 12, 2021
Does sex affect the risk of 30-day all-cause mortality in cardiogenic shock?
Alexander Schmitt1, Tobias Schupp1, Jonas Rusnak1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany; European Center for AngioScience (ECAS), German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany.
Insights
This study found that sex does not impact 30-day mortality risk in patients experiencing cardiogenic shock (CS), regardless of the cause. These findings suggest sex is not a prognostic factor in CS outcomes.
Area of Science:
- Cardiology
- Clinical Medicine
- Outcomes Research
Background:
- Cardiogenic shock (CS) is associated with high mortality rates.
- Limited data exists on the prognostic value of sex in CS patients.
- Investigating sex as a prognostic factor is crucial for understanding CS outcomes.
Purpose of the Study:
- To determine the prognostic value of sex in patients with cardiogenic shock.
- To compare the 30-day all-cause mortality between males and females with CS.
- To assess the influence of sex on mortality risk stratified by CS etiology (AMI-related vs. non-AMI-related).
Main Methods:
- A cohort of 273 consecutive CS patients (2019-2021) was analyzed.
- 30-day all-cause mortality was compared between sexes using Kaplan-Meier analysis.
- Multivariable Cox proportional regression models were used for risk stratification and adjustment.
- Analyses were performed separately for acute myocardial infarction-related CS (AMI-CS) and non-AMI-CS.
Main Results:
- Overall, 60% of CS patients were male and 40% were female.
- No significant difference in 30-day all-cause mortality was observed between males and females (56% vs. 56%; p=0.785).
- Sex remained non-significant after multivariable adjustment (HR=1.057; p=0.784).
- Mortality risks were comparable between sexes for both AMI-CS (64.0% vs. 64.6%) and non-AMI-CS (46.2% vs. 49.2%).
Conclusions:
- Sex is not associated with 30-day all-cause mortality in patients with cardiogenic shock.
- This finding holds true irrespective of the underlying etiology of CS.
- The study provides evidence that sex does not serve as an independent prognostic factor in CS.
Background:
Mortality rates following cardiogenic shock (CS) have stagnated on an unacceptably high level. Limited data regarding the prognostic value of sex in patients suffering from CS is available. Therefore, this study aims to investigate the prognostic value of sex in patients with CS.
Methods:
Consecutive patients with CS of any cause were included from 2019 to 2021. Prognosis of females was compared to males regarding 30-day all-cause mortality. Further risk stratification was performed according to the presence or absence of CS related to acute myocardial infarction (AMI). Kaplan-Meier and multivariable Cox proportional regression analyses were applied for statistics.
Results:
From a total of 273 CS patients (AMI-CS: 49%; non-AMI-CS: 51%), 60% were males and 40% females. The risk of 30-day all-cause mortality did not differ among males and females (56% vs. 56%; log rank p = 0.775; HR = 1.046; 95% CI 0.756-1.447; p = 0.785). Even after multivariable adjustment, sex was not associated with prognosis in CS patients (HR = 1.057; 95% CI 0.713-1.564; p = 0.784). Comparable risks of short-term mortality in both sexes were observed irrespective of the presence of AMI-related CS (64.0% vs. 64.6%; log rank p = 0.642; HR = 1.103; 95% CI 0.710-1.713; p = 0.664) and non-AMI-related CS (46.2% vs. 49.2%; log rank p = 0.696; HR = 1.099; 95% CI 0.677-1.783; p = 0.704).
Conclusion:
Sex was not associated with the risk of 30-day all-cause mortality in CS patients irrespective of CS etiology. (clinicaltrials.gov identifier: NCT05575856).
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