• Karl Fengler, Georg Fuernau, Steffen Desch, Ingo Eitel, Franz-Josef Neumann, Hans-Georg Olbrich, Antoinette de Waha, Suzanne de Waha, Gert Richardt, Marcus Hennersdorf, Klaus Empen, Rainer Hambrecht, Jörg Fuhrmann, Michael Böhm, Janine Poess, Ruth Strasser, Steffen Schneider, Gerhard Schuler, Karl Werdan, Uwe Zeymer, and Holger Thiele.
• Department of Internal Medicine, Cardiology, University of Leipzig, Heart Center, Strümpellstraße 39, 04289, Leipzig, Germany.
• Clin Res Cardiol. 2015 Jan 1;104(1):71-8.

BackgroundCardiogenic shock (CS) complicating acute myocardial infarction (AMI) is associated with high mortality. Previous studies regarding gender-specific differences in CS are conflicting and there are insufficient data for the presence of gender-associated differences in the contemporary percutaneous coronary intervention era. Aim of this study was therefore to investigate gender-specific differences in a large cohort of AMI patients with CS undergoing contemporary treatment.MethodsIn the randomized Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial, 600 patients with CS complicating AMI undergoing early revascularization were assigned to therapy with or without intra-aortic balloon pump. We compared sex-specific differences in these patients with regard to baseline and procedural characteristics as well as short- and long-term clinical outcome.ResultsOf 600 patients 187 (31%) were female. Women were significantly older than men and had a significantly lower systolic and diastolic blood pressure at presentation (p < 0.05 for all). Diabetes mellitus and hypertension were more frequent in women, whereas smoking was more frequent in men (p < 0.05 for all). Women showed a higher mortality within the first day after randomization (p = 0.004). However, after multivariable adjustment this numerical difference was no longer statistically significant. No gender-related differences in clinical outcome were observed after 1, 6 and 12 months of follow-up.ConclusionIn this large-scale multicenter study in patients with CS complicating AMI, women had a worse-risk profile in comparison to men. No significant gender-related differences in treatment as well as short- and long-term outcome were observed.

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