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Some patients require mechanical circulatory support (MCS) as their condition deteriorates. Sex-specific differences in risk factors and outcomes of cardiovascular disease have previously been described but are inconclusive regarding the use of MCS in AMICS. We aimed to investigate these with a focus on long-term outcomes. Health claim data from AOK \u2013 Die Gesundheitskasse (local health care funds) for patients hospitalized with AMICS between January 1, 2014, and December 31, 2015, was descriptively analyzed. Then, a Cox proportional hazards model was used to adjust for confounders. We analyzed 10,023 patients, of which 477 (4.8%) were treated with veno-arterial extra-corporeal membrane oxygenation (V-A ECMO). In-hospital mortality was high, but similar between treatments (V-A ECMO 59.1%, no V-A ECMO 56.6%). Women had a higher median age (78.9\u00a0years, IQR 13.8 vs. 71.8\u00a0years, IQR 17.9; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), a different cardiovascular risk profile and in the conservatively treated patients underwent revascularization less often (69.2% vs. 77.1%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than men did. In a multivariate analysis, female sex was not associated with lower survival (HR 1.03, CI 0.98\u20131.09; <jats:italic>p<\/jats:italic>\u2009=\u20090.233). V-A ECMO, however, was associated with lower survival in both sexes. We observed a low overall survival in follow-up after three years (no V-A ECMO: men 28.9% vs. women 21.7%, V-A ECMO: men 18.2% vs. women 17.0%). In conclusion,\u00a0women with AMICS presented with a different risk profile, especially a higher age, and underwent guideline-recommended therapies such as revascularization less often than men. Female sex, however, was not associated with lower survival in a multivariate analysis. In-hospital mortality was high, regardless of treatment, and V-A ECMO was associated with lower survival in follow-up.<\/jats:p>","DOI":"10.1007\/s00380-024-02509-z","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T10:19:33Z","timestamp":1734171573000},"page":"559-569","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sex-specific outcomes in acute myocardial infarction-associated cardiogenic shock treated with and without V-A ECMO: a retrospective German nationwide analysis from 2014 to 2018"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9754-7074","authenticated-orcid":false,"given":"Hendrik Willem","family":"Beckmeyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannik","family":"Feld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette","family":"K\u00f6ppe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Faldum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Dr\u00f6ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ruhnke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"G\u00fcnster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Reinecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-S\u00f6ren","family":"Padberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,14]]},"reference":[{"key":"2509_CR1","doi-asserted-by":"publisher","first-page":"451","DOI":"10.4244\/EIJ-D-20-01296","volume":"17","author":"H Thiele","year":"2021","unstructured":"Thiele H, De Waha-Thiele S, Freund A, Zeymer U, Desch S, Fitzgerald S (2021) Management of cardiogenic shock. 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Jeanette K\u00f6ppe reports research funding from the German Society for Trauma Surgery sponsored by Stryker, outside the submitted work. Holger Reinecke reports personal fees from Daiichi, grants from BMS\/Pfizer, personal fees from MedUpdate, personal fees from DiaPlan, personal fees from NeoVasc, grants and personal fees from Pluristem, grants from Bard, grants from Biotronik, personal fees from NovoNordisk, outside the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Our study was approved by the Ethics Committee Westfalen-Lippe (No 2019\u201321-f-S) and conducted in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"As only anonymized insurance data was used, no prior written informed patient consent for the analyzed data had to be obtained according to German law.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}