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Gender disparities with the use of percutaneous left ventricular assist device in patients undergoing percutaneous coronary intervention complicated by cardiogenic shock: From pVAD Working Group
- Source :
- Indian Heart Journal, Indian Heart Journal, Vol 70, Iss, Pp S90-S95 (2018)
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background: Hemodynamic support with Impella (Abiomed Inc., Danvers, MA) devices is becoming a more prevalent treatment option for patients with cardiogenic shock (CS) undergoing percutaneous coronary intervention (PCI). There exists only limited published data regarding outcome differences between male and female patients. Therefore, the objective of this paper is to analyze these gender differences between short-term survival and in-hospital outcomes in those undergoing PCI with CS. Methods: Between January 2011 and July 2016, patients undergoing PCI with simultaneous use of Impella were identified. Only patients presenting with CS were included in the analysis. All-cause in-hospital mortality was the primary outcome. Using SAS 9.4 for propensity score matching, additional secondary outcomes were also compared. Results: The primary outcome was comparable between males and females (39.5% vs. 26.3%, p = 0.33) in CS patients. Secondary outcomes were also comparable and included: myocardial infarction, stroke, CS, heart failure, dialysis requirement, bleeding within 72 h, blood transfusion, dysrhythmia, composite of all complications, major adverse cardiac events. Survival at 30 days was equal in both groups. A reduced mortality in males was noted for pre-PCI initiation of Impella. Additionally, both genders who received pre-PCI Impella support, experienced a significant reduction in inotrope use. Conclusions: Despite the small number of cohorts, this study did not reveal any significant differences among gender with the use of percutaneous left ventricular assist devices for PCI in patients with acute myocardial infarction complicated by CS. However, initiation of Impella prior to PCI may be associated with improved mortality and morbidity in both genders. Keywords: Mechanical circulatory device, Cardiogenic shock, High-risk PCI, Gender
- Subjects :
- Male
medicine.medical_treatment
Coronary Artery Disease
030204 cardiovascular system & hematology
Postoperative Complications
0302 clinical medicine
Cause of Death
Hospital Mortality
030212 general & internal medicine
Myocardial infarction
pLVAD, percutaneous left ventricle assist device
High-risk PCI
Stroke
Impella
Incidence
Cardiogenic shock
Middle Aged
Mechanical circulatory device
Survival Rate
MCS, mechanical circulatory support
Cardiology
Female
Cardiology and Cardiovascular Medicine
Original article
CS, cardiogenic shock
medicine.medical_specialty
RD1-811
Heart Ventricles
Shock, Cardiogenic
EKG, electrocardiogram
IABP, intraaortic balloon pump
03 medical and health sciences
Percutaneous Coronary Intervention
Sex Factors
Internal medicine
medicine
Diseases of the circulatory (Cardiovascular) system
Humans
cardiovascular diseases
Sex Distribution
Aged
Retrospective Studies
PCI, percutaneous coronary intervention
business.industry
Gender
Percutaneous coronary intervention
medicine.disease
United States
AMI, acute myocardial infarction
RC666-701
Ventricular assist device
Heart failure
Conventional PCI
Surgery
Heart-Assist Devices
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00194832
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- Indian Heart Journal
- Accession number :
- edsair.doi.dedup.....215cdebf2987081b23edf0f2c9668cb7