Cardiogenic Shock; Health Disparities; Equity; Mechanical Circulatory Support; Sex Differences; Multidisciplinary...

Area of Science:

• Cardiology
• Health Equity
• Healthcare Disparities

Background:

• Cardiogenic shock (CS) management has advanced, yet significant disparities in care persist.
• Clinical guidelines exist, but their equitable application remains a challenge.

Purpose of the Study:

• To examine the reasons behind persistent disparities in cardiogenic shock (CS) management.
• To synthesize structural, clinical, and ethical factors influencing access to advanced CS care.
• To highlight equity-oriented solutions for improving CS treatment.

Main Methods:

• Review of contemporary cohorts and existing literature on cardiogenic shock (CS) management.
• Synthesis of structural, clinical, and ethical mechanisms contributing to care gaps.
• Analysis of factors influencing access to timely and advanced CS therapies.

Main Results:

• Women, older adults, racial/ethnic minorities, and socioeconomically disadvantaged patients receive guideline-recommended therapies less often (20-40% lower use).
• These disparities are linked to implicit bias, unequal resources, protocol issues, and triage decisions.
• Inter-hospital transfer delays are longer for these patient groups.

Conclusions:

• Equitable cardiogenic shock (CS) care requires more than protocols; it demands measurement, cultural responsiveness, and accountability.
• System-level changes, including equity-minded protocols, regional networks, and disparity-sensitive metrics, are crucial.
• Success in CS care must encompass equitable inclusion in all stages of treatment and decision-making, not just survival.