Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarction
BackgroundIt is crucial to investigate whether there are prognostic disparities among AMI-CS patients undergoing VA-ECMO support. However, there is currently limited data available from China.AimsTo evaluate the gender differences in the characteristics, management, and outcomes among patients with...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1461580/full |
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| author | Lingyue Qiu Yingzhong Lin Meiying Long Qingkuan Li Xiyong Sheng Ying Shi Changhua Mo Qili Huang Mengjie Wang Xubin Wu Ling Liu Zhengde Lu Guozheng Qiu Liwen Lyu Qingwei Ji |
| author_facet | Lingyue Qiu Yingzhong Lin Meiying Long Qingkuan Li Xiyong Sheng Ying Shi Changhua Mo Qili Huang Mengjie Wang Xubin Wu Ling Liu Zhengde Lu Guozheng Qiu Liwen Lyu Qingwei Ji |
| author_sort | Lingyue Qiu |
| collection | DOAJ |
| description | BackgroundIt is crucial to investigate whether there are prognostic disparities among AMI-CS patients undergoing VA-ECMO support. However, there is currently limited data available from China.AimsTo evaluate the gender differences in the characteristics, management, and outcomes among patients with AMI-CS received VA-ECMO support in China.MethodsPatients admitted with AMI-CS at the Chest Pain Center of Guangxi Zhuang Autonomous Region People's Hospital between 2018 and 2023 were included. Sex differences in baseline characteristics, in-hospital management, and outcomes were compared. The primary endpoint was in-hospital mortality. Propensity score matching (PSM) was performed to reduce the impact of baseline clinical differences. Cox regression analysis was conducted to assess the association between gender and in-hospital mortality.ResultsAmong 193 patients presenting with AMI-CS, 15.54% were women. Women were older (67.23 ± 13 vs. 60.37 ± 12.98, p = 0.0028), had a higher prevalence of comorbidities, and a lower proportion of smoking history. Women were less likely to receive vascular reconstruction (70% vs. 88%, p = 0.023), had a significantly shorter duration of ECMO support (2.72 days vs. 4.87 days, p = 0.027), as well as shorter hospitalization days compared to male patients (11.73 ± 10.52 vs. 16.89 ± 10.74, p = 0.026). In-hospital all-cause mortality was notably higher among female patients (90.0%) compared to male patients (71.2%, p = 0.023). However, after PSM, the difference in in-hospital mortality rates between genders was not statistically significant (p = 0.16).ConclusionIn this retrospective study, women were less likely to receive revascularization and exhibited worse in-hospital outcomes compared to men. However, the observed sex difference in in-hospital mortality was attenuated after adjusting for clinical characteristics and acute treatments among AMI-CS patients receiving ECMO support. |
| format | Article |
| id | doaj-art-07d76e58c8054865918660f0decf7cbe |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-07d76e58c8054865918660f0decf7cbe2025-08-20T03:47:33ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.14615801461580Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarctionLingyue Qiu0Yingzhong Lin1Meiying Long2Qingkuan Li3Xiyong Sheng4Ying Shi5Changhua Mo6Qili Huang7Mengjie Wang8Xubin Wu9Ling Liu10Zhengde Lu11Guozheng Qiu12Liwen Lyu13Qingwei Ji14Department of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaDepartment of Emergency, The People’s Hospital of Guangxi Zhuang Autonomous Region and Research Center of Cardiovascular Disease, Guang Xi Academy of Medical Sciences, Nanning, ChinaDepartment of Emergency, The People’s Hospital of Guangxi Zhuang Autonomous Region and Research Center of Cardiovascular Disease, Guang Xi Academy of Medical Sciences, Nanning, ChinaDepartment of Cardiology, Guangxi Chest Pain Center, The People’s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaBackgroundIt is crucial to investigate whether there are prognostic disparities among AMI-CS patients undergoing VA-ECMO support. However, there is currently limited data available from China.AimsTo evaluate the gender differences in the characteristics, management, and outcomes among patients with AMI-CS received VA-ECMO support in China.MethodsPatients admitted with AMI-CS at the Chest Pain Center of Guangxi Zhuang Autonomous Region People's Hospital between 2018 and 2023 were included. Sex differences in baseline characteristics, in-hospital management, and outcomes were compared. The primary endpoint was in-hospital mortality. Propensity score matching (PSM) was performed to reduce the impact of baseline clinical differences. Cox regression analysis was conducted to assess the association between gender and in-hospital mortality.ResultsAmong 193 patients presenting with AMI-CS, 15.54% were women. Women were older (67.23 ± 13 vs. 60.37 ± 12.98, p = 0.0028), had a higher prevalence of comorbidities, and a lower proportion of smoking history. Women were less likely to receive vascular reconstruction (70% vs. 88%, p = 0.023), had a significantly shorter duration of ECMO support (2.72 days vs. 4.87 days, p = 0.027), as well as shorter hospitalization days compared to male patients (11.73 ± 10.52 vs. 16.89 ± 10.74, p = 0.026). In-hospital all-cause mortality was notably higher among female patients (90.0%) compared to male patients (71.2%, p = 0.023). However, after PSM, the difference in in-hospital mortality rates between genders was not statistically significant (p = 0.16).ConclusionIn this retrospective study, women were less likely to receive revascularization and exhibited worse in-hospital outcomes compared to men. However, the observed sex difference in in-hospital mortality was attenuated after adjusting for clinical characteristics and acute treatments among AMI-CS patients receiving ECMO support.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1461580/fullcardiogenic shockacute myocardial infarctionextracorporeal membrane oxygenationgendermortality |
| spellingShingle | Lingyue Qiu Yingzhong Lin Meiying Long Qingkuan Li Xiyong Sheng Ying Shi Changhua Mo Qili Huang Mengjie Wang Xubin Wu Ling Liu Zhengde Lu Guozheng Qiu Liwen Lyu Qingwei Ji Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarction Frontiers in Cardiovascular Medicine cardiogenic shock acute myocardial infarction extracorporeal membrane oxygenation gender mortality |
| title | Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarction |
| title_full | Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarction |
| title_fullStr | Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarction |
| title_full_unstemmed | Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarction |
| title_short | Gender disparities in patients treated with veno-arterial ECMO for cardiogenic shock complicating acute myocardial infarction |
| title_sort | gender disparities in patients treated with veno arterial ecmo for cardiogenic shock complicating acute myocardial infarction |
| topic | cardiogenic shock acute myocardial infarction extracorporeal membrane oxygenation gender mortality |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1461580/full |
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