title: Gender differences in patients with cardiogenic shock complicating myocardial infarction: a substudy of the IABP-SHOCK II-trial.
abstract: BACKGROUND
  Cardiogenic 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.
  
  
  METHODS
  In 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.
  
  
  RESULTS
  Of 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.
  
  
  CONCLUSIONS
  In 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.
authors.affiliation: Department of Internal Medicine, Cardiology, University of Leipzig, Heart Center, Strümpellstraße 39, 04289, Leipzig, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Fengler
authors.forename: Georg
authors.initials: G
authors.lastname: Fuernau
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Olbrich
authors.forename: Antoinette
authors.initials: A
authors.lastname: de Waha
authors.forename: Suzanne
authors.initials: S
authors.lastname: de Waha
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Marcus
authors.initials: M
authors.lastname: Hennersdorf
authors.forename: Klaus
authors.initials: K
authors.lastname: Empen
authors.forename: Rainer
authors.initials: R
authors.lastname: Hambrecht
authors.forename: Jörg
authors.initials: J
authors.lastname: Fuhrmann
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.forename: Janine
authors.initials: J
authors.lastname: Poess
authors.forename: Ruth
authors.initials: R
authors.lastname: Strasser
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Karl
authors.initials: K
authors.lastname: Werdan
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005858:Germany; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects / Q000401:mortality; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome