Gender Disparities on the Use and Outcomes of Mechanical Circulatory Support in Patients With Cardiogenic Shock Complicating Acute Myocardial Infarction.

Autor: Diaz-Arocutipa C; Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru. Electronic address: cdiazar@usil.edu.pe., Gamarra-Valverde NN; Facultad de Medicina 'Alberto Hurtado', Universidad Peruana Cayetano Heredia, Lima, Peru., Salguero R; Department of Cardiology, Hospital Universitario 12 de Octubre. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBERCV, Madrid, Spain., Martín-Asenjo R; Department of Cardiology, Hospital Universitario 12 de Octubre. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBERCV, Madrid, Spain., Vicent L; Department of Cardiology, Hospital Universitario 12 de Octubre. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBERCV, Madrid, Spain.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Dec 15; Vol. 233, pp. 65-73. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1016/j.amjcard.2024.09.031
Abstrakt: Cardiogenic shock complicating acute myocardial infarction (AMI-CS) remains a critical condition with high morbimortality. Despite advances, gender disparities persist in the management of this condition. Our aim was to evaluate gender differences in the utilization and outcomes of mechanical circulatory support (MCS) in AMI-CS. In addition, we addressed the management strategies for AMI-CS stratified by race/ethnicity. We performed a retrospective study using the National Inpatient Sample from 2016 to 2019, including admissions with AMI-CS. The use of MCS and outcomes were compared between genders using inverse probability of treatment weighting. Odds ratios (OR) with their 95% confidence interval (CI) were estimated. A total of 151,560 admissions for AMI-CS were analyzed, including 98,855 male and 52,705 female patients. After the inverse probability of treatment weighting adjustment, females were significantly less likely to receive MCS (OR 0.77, 95% CI 0.73 to 0.81, p <0.001) and had higher in-hospital mortality rates (OR 1.09, 95% CI 1.00 to 1.18, p = 0.045) than males. No significant gender differences were observed in major bleeding, renal replacement therapy, or mechanical ventilation. Racial disparities were also evident, with female patients across all racial groups being less likely to receive MCS compared with their male counterparts. In conclusion, significant gender disparities exist in the utilization and outcomes of MCS in patients with AMI-CS. Female patients are less likely to receive MCS and have higher in-hospital mortality rates compared with male patients. Racial minorities, including Black and Hispanic patients, experience lower utilization of MCS compared with White patients. These findings underscore the complex interplay between gender, race/ethnicity, and health care access and outcomes.
Competing Interests: Declaration of competing interest The authors have no competing interests to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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