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Women With AMI-Cardiogenic Shock Treated Less Aggressively

Coronary angiography, PCI, mechanical circulatory support used less often; mortality higher

TUESDAY, Sept. 29, 2020 (HealthDay News) — Among young adults with acute myocardial infarction-cardiogenic shock (AMI-CS), women are treated less aggressively and have higher in-hospital mortality than men, according to a study published online Sept. 29 in Circulation: Heart Failure.

Saraschandra Vallabhajosyula, M.D., from the Emory University School of Medicine in Atlanta, and colleagues identified a retrospective cohort from the National Inpatient Sample of individuals aged 18 to 55 years who were admitted for AMI-CS during 2000 to 2017. Data were included for 90,648 AMI-CS admissions; 26 percent of these admissions were among women.

The researchers found that the rates of CS were higher in men (2.2 percent in 2000 and 4.8 percent in 2017) compared with women (2.6 percent in 2000 and 4 percent in 2017). Women with AMI-CS were more often Black, had lower socioeconomic status and higher comorbidity, and were more often admitted to rural and small hospitals compared with men. Women experienced lower rates of ST-segment elevation presentation, acute noncardiac organ failure, and cardiac arrest; they also received less-frequent coronary angiography, early coronary angiography, percutaneous coronary intervention, and mechanical circulatory support. In-hospital mortality was independently predicted by female sex. Lower hospitalization costs were seen for women, but their length of stay was comparable to that of men.

“Further quantitative and qualitative research is needed in these vulnerable populations to better understand the underlying reasons for these differences in resource utilization in this high-risk population and what can be done to improve the outcome,” the authors write.

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