TCT-682 Gender Difference in the Outcomes of Patients With Spontaneous Coronary Artery Dissection Presenting With ST-Elevation Myocardial Infarction and Developing Cardiogenic Shock
Recommended Citation
Zordok M, Etiwy M, Abdelazeem M, Dani S, Lichaa H, Kerrigan J, Basir MB, Alaswad K, Brilakis E, Megaly M. TCT-682 Gender Difference in the Outcomes of Patients With Spontaneous Coronary Artery Dissection Presenting With ST-Elevation Myocardial Infarction and Developing Cardiogenic Shock. J Am Coll Cardiol 2024; 84(18):B262.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: There are limited data on gender differences among patients with spontaneous coronary artery dissection (SCAD) who present as ST-elevation myocardial infarction (STEMI) and develop cardiogenic shock (CS). We aim to describe outcomes of SCAD patients presenting with STEMI and CS and outline the differences between men and women. Methods: We queried the US Nationwide Readmissions Database (NRD) from January 2016 to December 2020 to identify patients with SCAD presenting with STEMI who developed CS. We compared the characteristics, trends, and outcomes between men and women in this cohort. Results: Of 582,633 hospitalizations with STEMI, 0.2% (1,176 patients) had SCAD, of whom 346 (29.4%) had CS. There was no difference in median age between men and women (64 years [IQR 57-71] vs 63 years [IQR 49-72], P = 0.181). Men had a higher prevalence of prior myocardial infarction (MI) (14.2% vs 6.2%, P = 0.021). The overall mortality rate of SCAD patients with AMI-CS was 26.3%, with no difference between men and women. Patients with SCAD who had CS and underwent CABG had a mortality of 20%. Extracorporeal membrane oxygenation (ECMO) was used in 5.4% of SCAD patients presenting with STEMI, and CS received ECMO with a survival rate of 54.5%. Conclusion: There were no differences in the baseline characteristics, rates of revascularization, or in-hospital mortality between men and women who had SCAD complicated by CS (SCAD-CS). Patients with SCAD-CS patients who underwent CABG had 80% in-hospital survival. CABG should be considered as a method of revascularization in this patient cohort. Categories: CORONARY: Hemodynamic Support, Cardiogenic Shock and Cardiac Arrest.
Volume
84
Issue
18
First Page
B262
