Volume 82, August 2024, 154785Author links open overlay panel, , , , , , , , , , , , , , , , , , , …AbstractBackground

Cardiogenic shock (CS) is the most severe form of acute heart failure. Discrepancies have been reported between sexes regarding delays, pathways and invasive strategies in CS complicating acute myocardial infarction. However, effect of sex on the prognosis of unselected CS remains controversial.

Objectives

The aim was to analyze the impact of sex on aetiology, management and prognosis of CS.

Methods

The FRENSHOCK registry included all CS admitted in 49 French Intensive Care Units (ICU) and Intensive Cardiac Care Units (ICCU) between April and October 2016.

Results

Among the 772 CS patients included, 220 were women (28.5%). Women were older, less smokers, with less history of ischemic cardiac disease (20.5% vs 33.6%) than men. At admission, women presented less cardiac arrest (5.5 vs 12.2%), less mottling (32.5 vs 41.4%) and higher LVEF (30 ± 14 vs 25 ± 13%). Women were more often managed via emergency department while men were directly admitted at ICU/ICCU. Ischemia was the most frequent trigger irrespective of sex (36.4% in women vs 38.2%) but women had less coronary angiogram and PCI (45.9% vs 54% and 24.1 vs 31.3%, respectively). We found no major difference in medication and organ support. Thirty-day mortality (26.4 vs 26.5%), transplant or permanent assist device were similar in both sexes.

Conclusion

Despite some more favorable parameters in initial presentation and no significant difference in medication and support, women shared similar poor prognosis than men. Further analysis is required to cover the lasting gap in knowledge regarding sex specificities to distinguish between differences and inequalities. NCT02703038

Keywords

Cardiogenic shock

Sex

Epidemiology

Management

Prognosis

AbbreviationsACS

acute coronary syndrome;

AMI

acute myocardial infarction;

AMICS

acute myocardial infarction associated cardiogenic shock;

CAG

coronary artery angiogram;

ECLS

extracorporeal life support;

ICCU

intensive cardiac care unit;

LVEF

left ventricular ejection fraction;

MCS

mechanical circulatory support;

PCI

Percutaneous Coronary Intervention,

VAD

ventricular assist device.

© 2024 The Authors. Published by Elsevier Inc.