Gender disparities in percutaneous coronary intervention in out-of-hospital cardiac arrest

Jeong, Jin Seop; Kong, So Yeon; Shin, Sang Do; Ro, Young Sun; Song, Kyoung Jun; Hong, Ki Jeong; Park, Jeong Ho; Kim, Tae Han

doi:10.1016/j.ajem.2018.06.068

Cited by 15 publications

(15 citation statements)

References 33 publications

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“…Our fundamental analysis showed that females generally received less post-admission interventions, such as PCI, CAG, and TTM, than males. Previous studies have shown that women are significantly less likely to receive PCI after OHCA than men, although the prognosis after PCI is not significantly related to sex [ 7 ]. Therefore, the survival of females after OHCA is lower than males, which may be related to the differences in medical services received after admission.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that there are significant differences in pathophysiology between men and women, and there may be different clinical symptoms and prognoses [ 5 , 6 ]. Compounding this, research has identified differences in the medical services received by males and females after admission [ 7 , 8 ]. The medical services include post-resuscitation care and nursing measures.…”

Section: Introductionmentioning

confidence: 99%

“…However, it is not clear whether sex differences in heart-related diseases affect the prognosis of OHCA. Multiple studies have addressed possible sex differences associated with OHCA prognosis, but the findings are inconsistent: some studies report no difference between males and females in survival after OHCA [ 7 , 11 ]; others have reported better survival for males or better survival for females [ 12 , 13 ]. A meta-analysis published in 2015 showed that the discharge survival rate of female OHCA patients was 10% higher than that of male, but the results of the latest large clinical studies show conflicting trends [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in survival after out-of-hospital cardiac arrest: a meta-analysis

Lei

Liu

et al. 2020

Crit Care

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Background Out-of-hospital cardiac arrest (OHCA) is a leading cause of sudden cardiac death worldwide. Researchers have found significant pathophysiological differences between females and males and clinically significant sex differences related to medical services. However, conflicting results exist and there is no uniform agreement regarding sex differences in survival and prognosis after OHCA. Therefore, we investigated the relationship between the prognosis of OHCA and sex factors. Methods We comprehensively searched the PubMed, Embase, and Cochrane databases and obtained a total of 1042 articles, from which 33 studies were selected for inclusion. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Results The meta-analysis included 1,268,664 patients. Compared with males, females were older (69.7 years vs. 65.4 years, p < 0.05) and more frequently suffered OHCA without witnesses (58.39% vs 62.70%, p < 0.05). Females were less likely to receive in-hospital interventions than males. There was no significant difference between females and males in the survival from OHCA to hospital admission (OR 0.99, 95% CI 0.89–1.1). However, females had lower chances for survival from hospital admission to discharge (OR 0.59, 95% CI 0.48–0.73), overall survival to hospital discharge (OR 0.73, 95% CI 0.62–0.86), and favorable neurological outcomes (OR 0.62, 95% CI 0.47–0.83) compared with males. Conclusions Our results indicate that the overall discharge survival rate of females is lower than that of males, and females face a poor prognosis of the nervous system. This is likely related to the pathophysiological characteristics of females, more conservative treatment measures compared with males, and different post-resuscitation care. However, these findings should be interpreted with caution due to the presence of several confounding factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sex differences in survival after out-of-hospital cardiac arrest: a meta-analysis

Lei

Liu

et al. 2020

Crit Care

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“…3,11 In recent years, sex differences in patients with OHCA are being increasingly recognized in both pathophysiology and treatment of CAD. 12,13,14,15 Studies including cardiac arrest patients with all initial rhythms and presumed cardiac aetiology have shown that almost 80% of patients are male 12,14,16,17,18 and that cardiac arrest due to an initial shockable rhythm is more common in men than women. 12,15,17,18,19 If women suffer from OHCA, they are often older 15,17,19,20 , and have a higher cardiovascular risk profile than men.…”

mentioning

confidence: 99%

“…12,13,14,15 Studies including cardiac arrest patients with all initial rhythms and presumed cardiac aetiology have shown that almost 80% of patients are male 12,14,16,17,18 and that cardiac arrest due to an initial shockable rhythm is more common in men than women. 12,15,17,18,19 If women suffer from OHCA, they are often older 15,17,19,20 , and have a higher cardiovascular risk profile than men. 12,19 Present data on the association between sex and OHCA-related survival is mainly based on national registries containing a heterogeneous patient population.…”

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confidence: 99%

Sex differences in patients with out-of-hospital cardiac arrest without ST-segment elevation: A COACT trial substudy

et al. 2021

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Background: Whether sex is associated with outcomes of out-of-hospital cardiac arrest (OHCA) is unclear.Objectives: This study examined sex differences in survival in patients with OHCA without ST-segment elevation myocardial infarction (STEMI).Methods: Using data from the randomized controlled Coronary Angiography after Cardiac Arrest (COACT) trial, the primary point of interest was sex differences in OHCA-related one-year survival. Secondary points of interest included the benefit of immediate coronary angiography compared to delayed angiography until after neurologic recovery, angiographic and clinical outcomes.Results: In total, 522 patients (79.1% men) were included. Overall one-year survival was 59.6% in women and 63.4% in men (HR 1.18; 95% CI: 0.76-1.81;p = 0.47). No cardiovascular risk factors were found that modified survival. Women less often had significant coronary artery disease (CAD) (37.0% vs. 71.3%;p < 0.001), but when present, they had a worse prognosis than women without CAD (HR 3.06; 95% CI 1.31À7.19;p = 0.01). This was not the case for men (HR 1.05; 95% CI 0.67À1.65;p = 0.83). In both sexes, immediate coronary angiography did not improve one-year survival compared to delayed angiography (women, odds ratio (OR) 0.87; 95% CI 0.58À1.30;p = 0.49; vs. men, OR 0.97; 95% CI 0.45À2.09;p = 0.93). Conclusion:In OHCA patients without STEMI, we found no sex differences in overall one-year survival. Women less often had significant CAD, but when CAD was present they had worse survival than women without CAD. This was not the case for men. Both sexes did not benefit from a strategy of immediate coronary angiography as compared to delayed strategy with respect to one-year survival.Clinical trial registration number: Netherlands trial register (NTR) 4973.

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Factors Underlying Racial and Gender Disparities in Sepsis Management

Ko¹,

Suh²

2023

The Sepsis Codex

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Gender disparities in percutaneous coronary intervention in out-of-hospital cardiac arrest

Cited by 15 publications

References 33 publications

Sex differences in survival after out-of-hospital cardiac arrest: a meta-analysis

Sex differences in survival after out-of-hospital cardiac arrest: a meta-analysis

Sex differences in patients with out-of-hospital cardiac arrest without ST-segment elevation: A COACT trial substudy

Factors Underlying Racial and Gender Disparities in Sepsis Management

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