Sex differences in patients with cardiogenic shock
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Sex differences in patients with cardiogenic shock. / Yan, Isabell; Schrage, Benedikt; Weimann, Jessica; Dabboura, Salim; Hilal, Rafel; Beer, Benedikt N; Becher, Peter Moritz; Seiffert, Moritz; Magnussen, Christina; B Schnabel, Renate; Kirchhof, Paulus; Blankenberg, Stefan; Westermann, Dirk.
In: ESC HEART FAIL, Vol. 8, No. 3, 06.2021, p. 1775-1783.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Sex differences in patients with cardiogenic shock
AU - Yan, Isabell
AU - Schrage, Benedikt
AU - Weimann, Jessica
AU - Dabboura, Salim
AU - Hilal, Rafel
AU - Beer, Benedikt N
AU - Becher, Peter Moritz
AU - Seiffert, Moritz
AU - Magnussen, Christina
AU - B Schnabel, Renate
AU - Kirchhof, Paulus
AU - Blankenberg, Stefan
AU - Westermann, Dirk
N1 - © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2021/6
Y1 - 2021/6
N2 - AIMS: Differences between female and male patients in clinical presentation, causes and treatment of cardiogenic shock (CS) are poorly understood. We aimed to investigate sex differences in presentation with and treatment of CS.METHODS AND RESULTS: We analysed data of 978 patients presenting with CS to a tertiary care hospital between October 2009 and October 2017. Multivariable adjusted logistic/Cox regression models were fitted to investigate the association between sex and clinical presentation, use of treatments and 30 day mortality. Median age was 70 years (interquartile range 58-79 years), and 295 (30.2%) patients were female. After adjustment for multiple relevant confounders, female patients were more likely to be older [odds ratio (OR) 1.21, 95% confidence interval (CI) 1.02-1.42, P = 0.027], but other relevant presentation characteristics did not differ between both sexes. Despite the similar presentation, female patients were less likely to be treated with percutaneous left ventricular assist devices (OR 0.78, 95% CI 0.64-0.94, P = 0.010), but more likely to be treated with catecholamines (OR 1.21, 95% CI 1.02-1.44, P = 0.033) or vasopressors (OR 1.26, 95% CI 1.05-1.50, P = 0.012). A 30 day mortality risk in female patients was as high as in male patients (hazard ratio 1.08, 95% CI 1.00-1.18, P = 0.091).CONCLUSIONS: In this large, contemporary cohort, clinical presentation was comparable in female and male patients, and both sexes were associated with a comparably high mortality risk. Nevertheless, female patients received different treatment for CS and were most importantly less likely to be treated with percutaneous left ventricular assist devices.
AB - AIMS: Differences between female and male patients in clinical presentation, causes and treatment of cardiogenic shock (CS) are poorly understood. We aimed to investigate sex differences in presentation with and treatment of CS.METHODS AND RESULTS: We analysed data of 978 patients presenting with CS to a tertiary care hospital between October 2009 and October 2017. Multivariable adjusted logistic/Cox regression models were fitted to investigate the association between sex and clinical presentation, use of treatments and 30 day mortality. Median age was 70 years (interquartile range 58-79 years), and 295 (30.2%) patients were female. After adjustment for multiple relevant confounders, female patients were more likely to be older [odds ratio (OR) 1.21, 95% confidence interval (CI) 1.02-1.42, P = 0.027], but other relevant presentation characteristics did not differ between both sexes. Despite the similar presentation, female patients were less likely to be treated with percutaneous left ventricular assist devices (OR 0.78, 95% CI 0.64-0.94, P = 0.010), but more likely to be treated with catecholamines (OR 1.21, 95% CI 1.02-1.44, P = 0.033) or vasopressors (OR 1.26, 95% CI 1.05-1.50, P = 0.012). A 30 day mortality risk in female patients was as high as in male patients (hazard ratio 1.08, 95% CI 1.00-1.18, P = 0.091).CONCLUSIONS: In this large, contemporary cohort, clinical presentation was comparable in female and male patients, and both sexes were associated with a comparably high mortality risk. Nevertheless, female patients received different treatment for CS and were most importantly less likely to be treated with percutaneous left ventricular assist devices.
KW - Aged
KW - Female
KW - Heart-Assist Devices
KW - Hospital Mortality
KW - Humans
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Sex Characteristics
KW - Shock, Cardiogenic/epidemiology
U2 - 10.1002/ehf2.13303
DO - 10.1002/ehf2.13303
M3 - SCORING: Journal article
C2 - 33763997
VL - 8
SP - 1775
EP - 1783
JO - ESC HEART FAIL
JF - ESC HEART FAIL
SN - 2055-5822
IS - 3
ER -
