METHODS: A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Studies were searched via the MEDLINE/PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to December 2022.
RESULTS: The analysis included 24 studies comprising 1,567,660 patients. Compared to females, males with CS had a significantly lower risk of in-hospital all-cause mortality (risk ratio [RR] 0.88, 95 % confidence interval [CI] 0.85-0.90, p < 0.001) and 1-year mortality (RR 0.90, 95 % CI 0.89-0.92, p < 0.001). Males were more likely to undergo percutaneous coronary intervention (RR 1.21, 95 % CI 1.13-1.31, p < 0.0001) and intra-aortic balloon pump placement (RR 1.21, 95 % CI 1.11-1.32, p < 0.0001), with no significant sex differences in the use of extracorporeal membrane oxygenation or Impella. During the index hospitalization, males were at higher risk of arrhythmias (RR 1.18, 95 % CI 1.05-1.34, p = 0.003) and less likely to develop acute kidney injury (RR 0.86, 95 % CI 0.79-0.94, p < 0.001).
CONCLUSIONS: Men have a lower all-cause mortality risk in cardiogenic shock. Addressing disparities in management is crucial for improving CS outcomes, especially for women.
方法:使用系统评价和荟萃分析的首选报告项目(PRISMA)方法进行系统评价和荟萃分析。通过MEDLINE/PubMed搜索研究,EMBASE,和Cochrane中央对照试验注册数据库从成立到2022年12月。
结果:分析包括24项研究,包括1,567,660名患者。与女性相比,男性CS患者院内全因死亡率(风险比[RR]0.88,95%置信区间[CI]0.85-0.90,p<0.001)和1年死亡率(RR0.90,95%CI0.89-0.92,p<0.001)风险显著较低.男性更可能接受经皮冠状动脉介入治疗(RR1.21,95%CI1.13-1.31,p<0.0001)和主动脉内球囊反搏置入术(RR1.21,95%CI1.11-1.32,p<0.0001),在使用体外膜氧合或Impella方面没有显着的性别差异。在住院期间,男性发生心律失常的风险较高(RR1.18,95%CI1.05-1.34,p=0.003),发生急性肾损伤的可能性较低(RR0.86,95%CI0.79-0.94,p<0.001).
结论:男性心源性休克的全因死亡风险较低。解决管理方面的差异对于改善CS结果至关重要,尤其是对于女性。