Clinical Differences and Disparities Among Men and Women With Acute Myocardial Infarction-Related Cardiogenic Shock Undergoing Percutaneous Coronary Intervention.

There is limited sex-specific data on patients with acute myocardial infarction-related cardiogenic shock (AMI-CS), and little is known about the optimal management in female patients, including the impact of mechanical circulatory support. This present study aims to evaluate sex-related clinical differences and disparities in the presentation, management, and outcome of male and female patients with AMI-CS who underwent percutaneous coronary intervention (PCI). Cardiogenic shock patients who underwent PCI at a large U.S. tertiary care center from 2012 onwards were included and stratified by sex. The primary outcome was all-cause death at 1 year after PCI. Survival curves were derived using the Cox proportional hazards regression model and covariate adjustment for confounders was performed. A total of 349 patients were included, and 106 (30.4%) were female. Baseline characteristics were similar with the exception of anemia, hypertension, and kidney disease, which were more common in female patients. Females were significantly less likely to receive a microaxial flow pump (21.7% vs 38.3%, p = 0.003) but were significantly more likely to receive an intraortic balloon pump (64.2% vs 46.9%, p = 0.003). At 1-year follow up, female patients had a higher incidence of all-cause death compared to male patients (48.0% vs 36.8%, hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.01 to 2.10), with early separation of curves within 30 days. In conclusion, among patients presenting with AMI-CS, female patients had a significantly higher unadjusted mortality at 1 year. These findings highlight the need for further investigation into the optimal management of AMI-CS in female patients.