Women with infarct-related cardiogenic shock had 60% 180-day mortality and did not benefit from mechanical circulatory support, unlike men where MCS reduced mortality.
Does sex impact the efficacy of routine mechanical circulatory support devices in reducing 180-day all-cause mortality in patients with infarct-related cardiogenic shock?
Routine use of mechanical circulatory support in infarct-related cardiogenic shock reduces mortality in selected men but provides no benefit to women, highlighting a critical sex disparity in treatment efficacy.
Absolute Event Rate: 0% vs 0%
Abstract Background In a recent meta-analysis, the routine use of mechanical circulatory support (MCS) improved outcomes only in a selected group of patients with infarct-related cardiogenic shock (CS). Here, we investigated whether sex might have an impact on the efficacy of MCS. Methods Patients from nine randomized clinical trials investigating the routine use of different MCS devices were included in this subanalysis. The efficacy of MCS between women and men across the total population was investigated, in unloading and loading devices and in patients with STEMI and low-likelihood of brain injury (Dan-Ger-Shock like population). The primary endpoint was 180-day all-cause mortality. Results Nine trials (n=1059 patients) were included, comprising 4 loading and 5 unloading device trials. Of the total cohort, 213 (20%) were women, who were on average 4 years older than men and exhibited a significantly higher 180-day mortality (60% versus 52%, p=0.03). The figure depicts the impact of sex on MCS efficacy with respect to the total cohort and subgroups. There was a significant interaction between sex and the efficacy of MCS in the subgroups of unloading devices and Dan-Ger-Shock like patients. Conclusions Women with infarct-related CS do not benefit from the routine use of MCS, regardless of device or patient selection, while MCS in men with STEMI and a low-likelihood of brain injury reduces mortality. The reasons for this sex disparity needs further research.Sex differences in MCS efficacy
Buellesbach et al. (Sat,) reported a other. Women with infarct-related cardiogenic shock had 60% 180-day mortality and did not benefit from mechanical circulatory support, unlike men where MCS reduced mortality.