Gender differences in long-term outcome of patients with cardiogenic shock complicating acute coronary syndrome

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Abstract Introduction Cardiogenic shock (CS) remains the leading cause of death in patients with acute coronary syndrome (ACS). Women are at higher risk of mortality from ACS, and less likely to receive medical and invasive therapy including mechanical circulating support device. Previous studies regarding gender specific differences in patients with CS complicating ACS have not yield consistent results and were not fully elucidated. Purpose The aim of the present study was to evaluate gender-specific difference in the clinical characteristics and the long-term outcome of CS complicating ACS patients. Methods We retrospectively investigated 2325 consecutive patients with ACS who underwent primary percutaneous coronary intervention (pPCI) in our institution from January 2004 to December 2017. The primary outcome was cardiovascular (CV) death up to 3 years. Results Among the 2325 eligible patients, 273 ACS patients (11.7%) were complicated by CS. Of 273 CS complicating ACS, a total of 69 (25.3%) patients were female. The mean age was 71 years, ST-elevation myocardial infarction (STEMI) was seen in 88%. Female gender was significant older (76±10.4 vs. 67.1±12.8, p<0.001). First medical contact (FMC) to device time was comparable between gender (p=0.58), and the use of mechanical circulatory support was not significantly different by gender (53.6% vs. 64.2%, p=0.12). Kaplan-Meier analysis showed that CV mortality up to 3 years was comparable between gender (P=0.87). Multivariate Cox regression analysis showed female gender was not significantly associated with long-term CV mortality (adjusted HR 1.15, 95%CI 0.71-1.85, P=0.56). Conclusions No significant gender-specific differences in long-term outcome of patients with CS complicating ACS were observed if appropriate treatment was provided.Figure 1(Study Flow Chart)Figure 2(CV mortality)

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