Prognostic effect of sex according to shock severity in patients with acute myocardial infarction complicated by cardiogenic shock

IF 2.7 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology Pub Date : 2025-03-01 DOI:10.1016/j.hjc.2023.11.007

Yeji Kim , Woo Jin Jang , Ik hyun Park , Ju Hyeon Oh , Jeong Hoon Yang , Hyeon-Cheol Gwon , Chul-Min Ahn , Cheol Woong Yu , Hyun-Joong Kim , Jang-Whan Bae , Sung Uk Kwon , Hyun-Jong Lee , Wang Soo Lee , Jin-Ok Jeong , Sang-Don Park

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引用次数: 0

Abstract

Background

Sex disparities in cardiogenic shock (CS) treatment are controversial, and the prognostic implications of sex remain unclear in CS caused by acute myocardial infarction (AMI).

Objectives

This study aimed to evaluate the prognostic effect of sex according to the severity of CS in patients undergoing percutaneous coronary intervention (PCI) for AMI complicated by CS.

Methods

We assessed 695 patients from 12 tertiary centers in South Korea who underwent PCI for AMI complicated by CS, and analyzed outcomes by sex (female [n = 184] vs. male [n = 511]). We compared a 12-month patient-oriented composite endpoint (POCE, defined as a composite of all-cause mortality, myocardial infarction, re-hospitalization due to heart failure, and repeat revascularization) between the sexes, respective of SCAI shock stage C&D or E. Propensity score-matched analysis was performed to reduce bias.

Results

We found that the female group was older and had higher vasoactive-inotropic and IABP-SHOCK II scores than the male group, with findings consistent across SCAI shock stages. During the 12-month follow-up period, multivariate analysis revealed no significant differences in POCE (HR 1.01, 95% CI 0.67–1.53, p = 0.963 for SCAI stage C&D, HR 1.24, 95% CI 0.84–1.84, p = 0.286 for SCAI stage E) between females and males. After propensity score matching, the incidence of POCE (HR 1.47, 95% CI 0.79–2.72, p = 0.220 for SCAI stage C&D, HR 0.88, 95% CI 0.49–1.57, p = 0.665 for SCAI stage E) was similar between sexes.

Conclusions

Sex does not appear to influence the risk of 12-month POCE in patients treated with PCI for CS caused by AMI, irrespective of shock severity.

Clinical Trial Registration

ClinicalTrials.gov NCT02985008. RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock), NCT02985008, Registered December 5, 2016 - retrospectively and prospectively.

IRB Information

This study was approved by the institutional review board of Samsung Medical Center (Reference number: 2016-03-130).

Abstract Image

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急性心肌梗死并发心源性休克患者休克严重程度对性别的预后影响

心源性休克(CS)治疗中的性别差异是有争议的，在急性心肌梗死(AMI)引起的CS中，性别对预后的影响尚不清楚。目的探讨性别对AMI合并CS患者行经皮冠状动脉介入治疗(PCI)时CS严重程度的影响。方法我们评估了来自韩国12个三级医疗中心的695例AMI合并CS接受PCI治疗的患者，并按性别(女性[n=184]与男性[n=511])分析了结果。我们比较了两性之间12个月的以患者为导向的复合终点(POCE，定义为全因死亡率、心肌梗死、心力衰竭再住院和重复血运重建的复合终点)，分别为SCAI休克期C&D或e。结果我们发现，与男性组相比，女性组年龄更大，血管活性肌力和IABP-SHOCK II评分更高，在SCAI休克阶段的发现是一致的。在12个月的随访期间，多因素分析显示，女性和男性的POCE无显著差异(SCAI c&d期HR 1.01, 95% CI 0.67-1.53, p=0.963, SCAI E期HR 1.24, 95% CI 0.84-1.84, p=0.286)。经倾向评分匹配后，男女之间POCE的发生率相似(SCAI期c&d的HR 1.47, 95% CI 0.79-2.72, p=0.220, SCAI期E的HR 0.88, 95% CI 0.49-1.57, p=0.665)。结论:无论休克严重程度如何，性别似乎不会影响AMI引起的CS接受PCI治疗的患者发生12个月POCE的风险。临床试验注册网站clinicaltrials .gov NCT02985008。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

7.30%

发文量

审稿时长

56 days

期刊介绍： The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.