Sex difference in outcomes and management of cardiogenic shock: A systematic review and meta-analysis

Department

Internal Medicine

Additional Department

Cardiology

Document Type

Article

Publication Title

Current Problems in Cardiology

Abstract

Background: Cardiogenic shock (CS) is associated with significant morbidity and mortality. Sex differences in the outcomes and management of cardiogenic shock are not well established. The primary objective of this study is to investigate the differences inik cardiogenic shock outcomes between males and females.

Methods: A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Studies were searched via the MEDLINE/PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to December 2022.

Results: The analysis included 24 studies comprising 1,567,660 patients. Compared to females, males with CS had a significantly lower risk of in-hospital all-cause mortality (risk ratio [RR] 0.88, 95 % confidence interval [CI] 0.85-0.90, p < 0.001) and 1-year mortality (RR 0.90, 95 % CI 0.89-0.92, p < 0.001). Males were more likely to undergo percutaneous coronary intervention (RR 1.21, 95 % CI 1.13-1.31, p < 0.0001) and intra-aortic balloon pump placement (RR 1.21, 95 % CI 1.11-1.32, p < 0.0001), with no significant sex differences in the use of extracorporeal membrane oxygenation or Impella. During the index hospitalization, males were at higher risk of arrhythmias (RR 1.18, 95 % CI 1.05-1.34, p = 0.003) and less likely to develop acute kidney injury (RR 0.86, 95 % CI 0.79-0.94, p < 0.001).

Conclusion: Men have a lower all-cause mortality risk in cardiogenic shock. Addressing disparities in management is crucial for improving CS outcomes, especially for women.

First Page

102777

DOI

10.1016/j.cpcardiol.2024.102777

Volume

49

Issue

11

Publication Date

11-1-2024

Medical Subject Headings

Humans; Shock, Cardiogenic (therapy, mortality); Sex Factors; Female; Male; Hospital Mortality (trends); Disease Management; Intra-Aortic Balloon Pumping (methods, statistics & numerical data); Treatment Outcome

PubMed ID

39103132

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