ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Sex disparities in revascularization strategies and mortality in infarct-related cardiogenic shock.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Abstract
backgroundCardiogenic shock (CS) remains the leading cause of death in acute myocardial infarction (AMI). Sex-related disparities in AMI-CS have been reported, but findings vary across cohorts.
objectivesThe authors examined the clinical characteristics and in-hospital outcomes of consecutive women and men with AMI-CS.
methodsThe ALKK coronary angiography (CAG) registry prospectively enrolled consecutive CAG and percutaneous coronary interventions (PCI) across 51 participating hospitals in Germany.
resultsBetween January 2009 and December 2020, a total of 4204 patients undergoing CAG for suspected AMI-CS were included. Women (30.5%, n = 1281) were on average 6 years older (74.3 vs. 68.0 years, P < .001) and had more comorbidities. They less frequently had significant coronary artery disease (CAD), 82.3% vs. 90.3%, P < .001. No significant sex differences in the recommendation for revascularization (PCI or CABG) among patients with significant CAD after adjustment for age (92.4% vs. 91.3%, adjusted OR: 1.3; 95% CI: 0.99-1.72) were observed. There were no sex differences in hospital mortality after adjustment for age, particularly in the PCI group, age-adjusted OR: 1.06; 95% CI: 0.90-1.25, multivariable adjusted OR: 1.09; 95% CI: 0.92-1.28.
conclusionsIn this large, contemporary registry, women with early CAG for AMI-CS were older than men and had more comorbidities. Significant CAD was less frequently diagnosed in women with suspected AMI-CS. After adjustment for age, there were neither sex differences in revascularization strategies nor in hospital mortality after PCI for AMI-CS. These results question previous reports about undertreatment and higher mortality of AMI-CS in women.
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