• Stéphane Manzo-Silberman, Anne-Céline Martin, Florence Boissier, Caroline Hauw-Berlemont, Nadia Aissaoui, Nicolas Lamblin, François Roubille, Eric Bonnefoy, Laurent Bonello, Meyer Elbaz, Guillaume Schurtz, Olivier Morel, Guillaume Leurent, Bruno Levy, Bernard Jouve, Brahim Harbaoui, Gérald Vanzetto, Nicolas Combaret, Benoit Lattucca, Sébastien Champion, Pascal Lim, Cédric Bruel, Francis Schneider, Marie-France Seronde, Vincent Bataille, Edouard Gerbaud, Etienne Puymirat, Clément Delmas, and FRENSHOCK investigators.
• Sorbonne University, Institute of Cardiology- Hôpital Pitié-Salpêtrière (AP-HP), ACTION Study Group, Paris, France; Université de Paris, INSERM, Innovative Therapies in Haemostasis, 75006 Paris, France; Intensive Care Unit, Department of Cardiology, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, F-13385 Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15 Lyon, France; AP-HP, Hôpital Universitaire Henri-Mondor, Service de Cardiologie, F-94010 Créteil, France; Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Bordeaux U1045, France; Université de Paris, 75006 Paris, France. Electronic address: stephane.manzosilberman@aphp.fr.
• J Crit Care. 2024 Mar 16; 82: 154785154785.

BackgroundCardiogenic shock (CS) is the most severe form of acute heart failure. Discrepancies have been reported between sexes regarding delays, pathways and invasive strategies in CS complicating acute myocardial infarction. However, effect of sex on the prognosis of unselected CS remains controversial.ObjectivesThe aim was to analyze the impact of sex on aetiology, management and prognosis of CS.MethodsThe FRENSHOCK registry included all CS admitted in 49 French Intensive Care Units (ICU) and Intensive Cardiac Care Units (ICCU) between April and October 2016.ResultsAmong the 772 CS patients included, 220 were women (28.5%). Women were older, less smokers, with less history of ischemic cardiac disease (20.5% vs 33.6%) than men. At admission, women presented less cardiac arrest (5.5 vs 12.2%), less mottling (32.5 vs 41.4%) and higher LVEF (30 ± 14 vs 25 ± 13%). Women were more often managed via emergency department while men were directly admitted at ICU/ICCU. Ischemia was the most frequent trigger irrespective of sex (36.4% in women vs 38.2%) but women had less coronary angiogram and PCI (45.9% vs 54% and 24.1 vs 31.3%, respectively). We found no major difference in medication and organ support. Thirty-day mortality (26.4 vs 26.5%), transplant or permanent assist device were similar in both sexes.ConclusionDespite some more favorable parameters in initial presentation and no significant difference in medication and support, women shared similar poor prognosis than men. Further analysis is required to cover the lasting gap in knowledge regarding sex specificities to distinguish between differences and inequalities. NCT02703038.Copyright © 2024. Published by Elsevier Inc.

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