Sex disparities in cardiogenic shock: Insights from the FRENSHOCK registry - Université de Paris - Faculté de Santé Access content directly
Journal Articles Journal of Critical Care Year : 2024

Sex disparities in cardiogenic shock: Insights from the FRENSHOCK registry

Caroline Hauw-Berlemont
  • Function : Author
Nadia Aissaoui
  • Function : Author
Eric Bonnefoy
  • Function : Author
Laurent Bonello
  • Function : Author
Meyer Elbaz
  • Function : Author
Olivier Morel
  • Function : Author
Bruno Levy
  • Function : Author
Bernard Jouve
  • Function : Author
Brahim Harbaoui
Gérald Vanzetto
  • Function : Author
Nicolas Combaret
  • Function : Author
Benoit Lattucca
  • Function : Author
Sébastien Champion
  • Function : Author
Cédric Bruel
  • Function : Author
Francis Schneider
  • Function : Author
Marie-France Seronde
  • Function : Author
Vincent Bataille
  • Function : Author
Edouard Gerbaud
  • Function : Author
Etienne Puymirat
  • Function : Author

Abstract

Background: Cardiogenic shock (CS) is the most severe form of acute heart failure. Discrepancies have been reported between sexes regarding delays, pathways and invasive strategies in CS complicating acute myocardial infarction. However, effect of sex on the prognosis of unselected CS remains controversial.Objectives: The aim was to analyze the impact of sex on aetiology, management and prognosis of CS.Methods: The FRENSHOCK registry included all CS admitted in 49 French Intensive Care Units (ICU) and Intensive Cardiac Care Units (ICCU) between April and October 2016.Results: Among the 772 CS patients included, 220 were women (28.5%). Women were older, less smokers, with less history of ischemic cardiac disease (20.5% vs 33.6%) than men. At admission, women presented less cardiac arrest (5.5 vs 12.2%), less mottling (32.5 vs 41.4%) and higher LVEF (30 ± 14 vs 25 ± 13%). Women were more often managed via emergency department while men were directly admitted at ICU/ICCU. Ischemia was the most frequent trigger irrespective of sex (36.4% in women vs 38.2%) but women had less coronary angiogram and PCI (45.9% vs 54% and 24.1 vs 31.3%, respectively). We found no major difference in medication and organ support. Thirty-day mortality (26.4 vs 26.5%), transplant or permanent assist device were similar in both sexes.Conclusion: Despite some more favorable parameters in initial presentation and no significant difference in medication and support, women shared similar poor prognosis than men. Further analysis is required to cover the lasting gap in knowledge regarding sex specificities to distinguish between differences and inequalities. NCT02703038.
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hal-04508490 , version 1 (22-05-2024)

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Stéphane Manzo-Silberman, Anne-Céline Martin, Florence Boissier, Caroline Hauw-Berlemont, Nadia Aissaoui, et al.. Sex disparities in cardiogenic shock: Insights from the FRENSHOCK registry. Journal of Critical Care, 2024, 82, pp.154785. ⟨10.1016/j.jcrc.2024.154785⟩. ⟨hal-04508490⟩
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