Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jun 26, 2021; 13(6): 170-176
Published online Jun 26, 2021. doi: 10.4330/wjc.v13.i6.170
Cardiogenic shock in the setting of acute myocardial infarction: Another area of sex disparity?
Syed Bukhari, Shumail Fatima, Islam Y Elgendy
Syed Bukhari, Shumail Fatima, Cardiovascular Medicine, University of Pittsburgh, Pittsburgh, PA 15261, United States
Islam Y Elgendy, Department of Medicine, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
Author contributions: Bukhari S, Fatima S designed, performed the collection of the data, edited, and wrote the paper; Elgendy IY contributed to the critical revision and editing of the paper.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Islam Y Elgendy, FACC, FACP, FAHA, MD, Assistant Professor, Consultant Physician-Scientist, Department of Medicine, Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha 24144, Qatar.
Received: March 11, 2021
Peer-review started: March 11, 2021
First decision: March 31, 2021
Revised: April 3, 2021
Accepted: May 21, 2021
Article in press: May 21, 2021
Published online: June 26, 2021

Cardiogenic shock in the setting of acute myocardial infarction (AMI) carries significant morbidity and mortality, despite advances in pharmacological, mechanical and reperfusion therapies. Studies suggest that there is evidence of sex disparities in the risk profile, management, and outcomes of cardiogenic shock complicating AMI. Compared with men, women tend to have more comorbidities, greater variability in symptom presentation and are less likely to receive timely revascularization and mechanical circulatory support. These factors might explain why women tend to have worse outcomes. In this review, we highlight sex-based differences in the prevalence, management, and outcomes of cardiogenic shock due to AMI, and discuss potential ways to mitigate them.

Keywords: Cardiogenic shock, Myocardial infarction, Sex, Morbidity

Core Tip: Sex disparities exist among different cardiovascular diseases and therapies. Cardiogenic shock is a leading cause of death among patients with acute myocardial infarction. Although some studies suggest that cardiogenic shock is more prevalent among women, women are less likely to receive guideline-recommended management including revascularization, which might explain why are more likely to experience worse outcomes.