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Gender differences in patients with cardiogenic shock complicating myocardial infarction: a substudy of the IABP-SHOCK II-trial.
- Source :
-
Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2015 Jan; Vol. 104 (1), pp. 71-8. Date of Electronic Publication: 2014 Oct 07. - Publication Year :
- 2015
-
Abstract
- Background: Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high mortality. Previous studies regarding gender-specific differences in CS are conflicting and there are insufficient data for the presence of gender-associated differences in the contemporary percutaneous coronary intervention era. Aim of this study was therefore to investigate gender-specific differences in a large cohort of AMI patients with CS undergoing contemporary treatment.<br />Methods: In the randomized Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial, 600 patients with CS complicating AMI undergoing early revascularization were assigned to therapy with or without intra-aortic balloon pump. We compared sex-specific differences in these patients with regard to baseline and procedural characteristics as well as short- and long-term clinical outcome.<br />Results: Of 600 patients 187 (31%) were female. Women were significantly older than men and had a significantly lower systolic and diastolic blood pressure at presentation (p < 0.05 for all). Diabetes mellitus and hypertension were more frequent in women, whereas smoking was more frequent in men (p < 0.05 for all). Women showed a higher mortality within the first day after randomization (p = 0.004). However, after multivariable adjustment this numerical difference was no longer statistically significant. No gender-related differences in clinical outcome were observed after 1, 6 and 12 months of follow-up.<br />Conclusion: In this large-scale multicenter study in patients with CS complicating AMI, women had a worse-risk profile in comparison to men. No significant gender-related differences in treatment as well as short- and long-term outcome were observed.
- Subjects :
- Aged
Aged, 80 and over
Chi-Square Distribution
Female
Germany
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction diagnosis
Myocardial Infarction mortality
Myocardial Infarction physiopathology
Odds Ratio
Proportional Hazards Models
Risk Assessment
Risk Factors
Sex Factors
Shock, Cardiogenic diagnosis
Shock, Cardiogenic mortality
Shock, Cardiogenic physiopathology
Time Factors
Treatment Outcome
Coronary Artery Bypass adverse effects
Coronary Artery Bypass mortality
Intra-Aortic Balloon Pumping adverse effects
Intra-Aortic Balloon Pumping mortality
Myocardial Infarction complications
Myocardial Infarction therapy
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention mortality
Shock, Cardiogenic etiology
Shock, Cardiogenic therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1861-0692
- Volume :
- 104
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Clinical research in cardiology : official journal of the German Cardiac Society
- Publication Type :
- Academic Journal
- Accession number :
- 25287767
- Full Text :
- https://doi.org/10.1007/s00392-014-0767-2