PMID- 37834902
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240210
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 12
IP  - 19
DP  - 2023 Sep 28
TI  - The Impact of Sex on Cardiogenic Shock Outcomes Following ST Elevation Myocardial 
      Infarction.
LID - 10.3390/jcm12196259 [doi]
LID - 6259
AB  - BACKGROUND: Cardiogenic shock (CS) remains the leading cause of ST elevation 
      myocardial infarction (STEMI)-related mortality. Contemporary studies have shown 
      no sex-related differences in mortality. METHODS: STEMI-CS patients undergoing 
      primary percutaneous coronary intervention (PPCI) were included based on a 
      dedicated prospective STEMI database. We compared sex-specific differences in CS 
      characteristics at baseline, during hospitalization, and in subsequent clinical 
      outcomes. Endpoints included all-cause mortality and major adverse cardiac events 
      (MACE). RESULTS: Of 3202 consecutive STEMI patients, 210 (6.5%) had CS, of which 
      63 (30.0%) were women. Women were older than men (73.2 vs. 65.5% y, p < 0.01), 
      and more had hypertension (68.3 vs. 52.8%, p = 0.019) and diabetes (38.7 vs. 
      24.8%, p = 0.047). Fewer were smokers (13.3 vs. 41.2%, p < 0.01), had previous 
      PCI (9.1 vs. 22.3% p = 0.016), or required IABP (35.3 vs. 51.1% p = 0.027). Women 
      had higher rates of mortality (53.2 vs. 35.3% in-hospital, p = 0.01; 61.3 vs. 
      41.9% at 1 month, p = 0.01; and 73.8 vs. 52.6% at 3 years, p = 0.05) and MACE 
      (60.6 vs. 41.6% in-hospital, p = 0.032; 66.1 vs. 45.6% at 1 month, p = 0.007; and 
      62.9 vs. 80.3% at 3 years, p = 0.015). After multivariate adjustment, female sex 
      remained an independent factor for death (HR-2.42 [95% CI 1.014-5.033], p = 
      0.042) and MACE (HR-1.91 [95% CI 1.217-3.031], p = 0.01). CONCLUSIONS: CS 
      complicating STEMI is associated with greater short- and long-term mortality and 
      MACE in women. Sex-focused measures to improve diagnosis and treatment are 
      mandatory for CS patients.
FAU - Arnold, Joshua H
AU  - Arnold JH
AUID- ORCID: 0000-0002-7865-8983
AD  - Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, 
      USA.
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Perl, Leor
AU  - Perl L
AUID- ORCID: 0000-0002-0625-7937
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Assali, Abid
AU  - Assali A
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
AD  - Department of Cardiology, Meir Medical Center, Kfar-Saba 4428164, Israel.
FAU - Codner, Pablo
AU  - Codner P
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Greenberg, Gabriel
AU  - Greenberg G
AUID- ORCID: 0000-0003-4042-5786
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Samara, Abid
AU  - Samara A
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Porter, Avital
AU  - Porter A
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Orvin, Katia
AU  - Orvin K
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Kornowski, Ran
AU  - Kornowski R
AUID- ORCID: 0000-0002-7708-8253
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
FAU - Vaknin Assa, Hana
AU  - Vaknin Assa H
AUID- ORCID: 0000-0001-6935-9765
AD  - Department of Cardiology, Rabin Medical Center, Petach-Tikva 4941492, Israel.
AD  - School of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel.
LA  - eng
GR  - R38 HL155729/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20230928
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC10573491
OTO - NOTNLM
OT  - STEMI
OT  - cardiogenic shock
OT  - female
COIS- The authors declare no conflict of interest.
EDAT- 2023/10/14 10:48
MHDA- 2023/10/14 10:49
PMCR- 2023/09/28
CRDT- 2023/10/14 01:08
PHST- 2023/08/20 00:00 [received]
PHST- 2023/09/13 00:00 [revised]
PHST- 2023/09/27 00:00 [accepted]
PHST- 2023/10/14 10:49 [medline]
PHST- 2023/10/14 10:48 [pubmed]
PHST- 2023/10/14 01:08 [entrez]
PHST- 2023/09/28 00:00 [pmc-release]
AID - jcm12196259 [pii]
AID - jcm-12-06259 [pii]
AID - 10.3390/jcm12196259 [doi]
PST - epublish
SO  - J Clin Med. 2023 Sep 28;12(19):6259. doi: 10.3390/jcm12196259.