Cardiogenic Shock - Differences Between Males and Females and Sex Specific Risks

Can J Physiol Pharmacol. 2024 Apr 25. doi: 10.1139/cjpp-2023-0382. Online ahead of print.

Abstract

Cardiogenic Shock (CS) remains a high-mortality condition despite technological and therapeutic advances. One key to potentially improving CS prognosis is understanding patient heterogeneity and which patients may benefit most from different treatment options, a key element of which is sex differences. While cardiovascular diseases have historically been thought of as a male-dominant conditions, the field is increasingly aware that females are also a substantial portion of the patient population. While estrogen has been implicated in protective roles against CVD and tissue hypoxia, it's role in CS remains unclear. Clinically, female CS patients tend to be older and have more severe comorbidities and are more likely to have non-acute myocardial infarction etiologies with preserved ejection fractions. Female CS patients are more likely to receive pharmacotherapy while less likely to receive mechanical circulatory support. There is increased short-term mortality in females, although long-term mortality is similar between the sexes. More sex-specific and age-stratified research needs to be done to fully understand the pathophysiological differences that are relevant in CS, to better recognize and manage CS patients and reduce its mortality.