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Gender Comparisons in Cardiogenic Shock During ST Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

Lookup NU author(s): Dr Vijay Kunadian, Dr Bilal Bawamia, Dr Murugu Veerasamy, Sheila Jamieson, Professor Azfar Zaman

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Abstract

Among patients hospitalized with acute myocardial infarction (AMID, cardiogenic shock (CS) is the leading cause of death, complicating up to 10% of admissions. Introduction of early revascularization strategies and mechanical ventricular support have seen short-term mortality associated with CS fall from 70% to 80% in the 1970s to approximately 50% to 60% in the 1990s. Previous studies reported a higher incidence of CS after AMI in women (11.6% vs 8.3%). The aims of this study were to determine hospital mortality outcomes and gender differences following primary percutaneous coronary intervention (PPCI) in the setting of CS. Data were collected prospectively among all patients undergoing PPCI for AMI at a large UK tertiary cardiac center between April 2008 and October 2011. A sample of 2,864 patients (women: 844 [29.5%]) underwent PPCI, of which 141 (4.9%) had a confirmed diagnosis of CS. Eighty-one of 2,019 [4.0%] male patients (mean age: 64.2 years) and 60 of 844 [7.1%]) female patients (mean age: 69.9 years) with CS underwent PPCI (p <0.001). The overall hospital mortality was 35.5% with no gender difference (male: 35.8% vs female: 35%, p >0.99). In conclusion, this analysis demonstrates that in the contemporary PPCI era, there is a reduction in the incidence of CS with reduced hospital mortality rates and no gender difference. The absence of a gender difference is remarkable because higher proportions of women presented with CS and were older than their male counterparts. Long-term follow-up data are required to determine if this difference is sustained. (C) 2013 Elsevier Inc. All rights reserved.


Publication metadata

Author(s): Kunadian V, Qiu WL, Bawamia B, Veerasamy M, Jamieson S, Zaman A

Publication type: Article

Publication status: Published

Journal: American Journal of Cardiology

Year: 2013

Volume: 112

Issue: 5

Pages: 636-641

Print publication date: 24/05/2013

ISSN (print): 0002-9149

ISSN (electronic): 1879-1913

Publisher: Excerpta Medica, Inc.

URL: http://dx.doi.org/10.1016/j.amjcard.2013.04.038

DOI: 10.1016/j.amjcard.2013.04.038


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