Sex differences in patients with cardiogenic shock

ESC Heart Failure

Dirk Westermann¹  Renate B. Schnabel¹  Isabell Yan¹  Rafel Hilal¹  Jessica Weimann¹  Benedikt N. Beer¹  Paulus Kirchhof¹  Moritz Seiffert¹  Salim Dabboura¹  Christina Magnussen¹  Benedikt Schrage¹  Stefan Blankenberg¹  Peter Moritz Becher¹ 

[1] Department of Cardiology University Heart and Vascular Center Hamburg Martinistraße 52 Hamburg 20246 Germany;

关键词: Cardiogenic shock;    Sex‐related differences;    Heart failure;   

DOI  :  10.1002/ehf2.13303

来源: DOAJ

【 摘 要 】

Abstract 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.

【 授权许可】

Unknown