Sex disparities in acute kidney injury complicating acute myocardial infarction with cardiogenic shock

Saraschandra Vallabhajosyula, Lina Ya'Qoub, Shannon M Dunlay, Saarwaani Vallabhajosyula, Shashaank Vallabhajosyula, Pranathi R. Sundaragiri, Allan S Jaffe, Bernard J. Gersh, Kianoush Kashani

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Aims: To evaluate sex-specific disparities in acute kidney injury (AKI) complicating acute myocardial infarction-related cardiogenic shock (AMI-CS) in the United States. Methods and results: This was a retrospective cohort study from 2000 to 2014 from the National Inpatient Sample (20% sample of all hospitals in the United States). Patients >18 years admitted with a primary diagnosis of AMI and concomitant CS that developed AKI were included. The endpoints of interest were the prevalence, trends, and outcomes of men and women with AKI in AMI-CS. Multivariable hierarchical logistic regression was used to control for confounding, and a two-sided P < 0.05 was considered statistically significant. During this 15 year period, 440 257 admissions with AMI-CS met the inclusion criteria, with AKI noted in 155 610 (35.3%). Women constituted 36.3% of the cohort and were older, of non-White race, and with higher co-morbidity compared with men. Women with AKI less often received coronary angiography (59% vs. 66%), percutaneous coronary intervention (39% vs. 43%), mechanical circulatory support (39% vs. 48%), mechanical ventilation (49% vs. 54%), and haemodialysis (9% vs. 10%) compared with men (all P < 0.001). Adjusted in-hospital mortality was higher in women—odds ratio 1.16 (95% confidence interval 1.14–1.19); P < 0.001—compared with men. Women had shorter lengths of stay (12 ± 14 vs. 13 ± 14 days), lower hospital costs ($150 071 ± 180 796 vs. $181 260 ± 209 674), and were less often discharged to home (19% vs. 31%) (all P < 0.001). Conclusions: Women with AKI in AMI-CS received fewer cardiac and non-cardiac interventions, had higher in-hospital mortality, and were less often discharged to home compared with men.

Original languageEnglish (US)
JournalESC Heart Failure
DOIs
StatePublished - Jan 1 2019

    Fingerprint

Keywords

  • Acute kidney injury
  • Acute myocardial infarction
  • Cardiogenic shock
  • Haemodialysis
  • Sex-based disparities

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Vallabhajosyula, S., Ya'Qoub, L., Dunlay, S. M., Vallabhajosyula, S., Vallabhajosyula, S., Sundaragiri, P. R., Jaffe, A. S., Gersh, B. J., & Kashani, K. (2019). Sex disparities in acute kidney injury complicating acute myocardial infarction with cardiogenic shock. ESC Heart Failure. https://doi.org/10.1002/ehf2.12482