Impact of Acute Myocardial Infarction Type on Prognosis in Female Patients With Cardiogenic Shock

• Published in: The American journal of cardiology 2023-11, Vol.206, p.116-124
• Main Authors: Jeon, Bo Kyung, Jang, Woo Jin, Park, Ik Hyun, Oh, Ju Hyeon, Yang, Jeong Hoon, Gwon, Hyeon-Cheol, Ahn, Chul-Min, Yu, Cheol Woong, Kim, Hyun-Joong, Bae, Jang-Whan, Kwon, Sung Uk, Lee, Hyun-Jong, Lee, Wang Soo, Jeong, Jin-Ok, Park, Sang-Don
• Format: Article
• Language: English
• Subjects: acute myocardial infarction; Aspirin; Blood clots; Blood pressure; cardiogenic shock; Coronary vessels; female; Females; Health hazards; Heart; Heart attacks; Hospitalization; Matching; Medical prognosis; Metabolic disorders; Mortality; Multivariate analysis; Myocardial infarction; NSTEMI; Prognosis; Segments; STEMI; Subgroups; Survival analysis; Veins & arteries
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2023.08.009

•In cases when acute myocardial infarction (AMI) is complicated by cardiogenic shock (CS), patients with non-ST-segment elevation myocardial infarction (non–STEMI) generally have lower short-term mortality rates than patients with STEMI.•Generally, female gender is recognized as a prognostic factor associated with worse outcomes in AMI with CS; however, most of the research has been focused on male patients.•Over a 12-month follow-up period, no significant differences were observed in the risk of major adverse cardiac events between the STEMI and non–STEMI groups.•In female patients with CS, AMI clinical type might not influence mid-term prognosis. There are limited data about mid-term prognosis according to acute myocardial infarction (AMI) type in female patients with AMI complicated by cardiogenic shock (CS). In this study, we evaluated the impact of AMI type on prognosis in female patients who underwent percutaneous coronary intervention (PCI) for AMI complicated by CS. A total of 184 female patients who underwent PCI for AMI complicated by CS were enrolled from 12 centers in the Republic of Korea. Patients were divided into 2 groups according to AMI type: the ST-segment elevation myocardial infarction (n = 114) and the non–ST-segment elevation myocardial infarction (n = 70) group. Primary outcome was a major adverse cardiac event (MACE) (defined as a composite of cardiac death, myocardial infarction, or repeat revascularization). Propensity-score matching analysis was performed to reduce selection bias and potential confounding factors. During 12-month follow-up, a total of 73 MACEs occurred (ST-segment elevation myocardial infarction group, 47 [41.2%] vs non–ST-segment elevation myocardial infarction group, 26 [37.1%], p = 0.643). Multivariate analysis revealed no significant difference in the incidence of MACE at 12 months between the 2 groups (adjusted hazard ratio 1.16, 95% confidence interval 0.70 to 2.37, p = 0.646). After propensity-score matching, the incidence of MACE at 12 months remained similar between the 2 groups (hazard ratio 1.31, 95% confidence interval 0.69 to 2.52, p = 0.413). The similarity in MACEs between the 2 groups was consistent across a variety of subgroups. In conclusion, after adjusting for baseline differences, AMI clinical type did not appear to increase the risk of MACEs at 12 months in female patients who underwent emergency PCI for AMI complicated by CS.