{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:12:17Z","timestamp":1779351137160,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Sex-specific outcome in patients with acute myocardial infarction-related cardiogenic shock (AMI-CS) receiving temporary mechanical circulatory support remains controversial. Materials and Methods: Patients with AMI-CS who received Impella support were prospectively enrolled in the Japanese registry for Percutaneous Ventricular Assist Device. Patients enrolled between January 2021 and December 2022 were considered to be eligible. Patients with out-of-hospital cardiac arrest and those without revascularization were excluded. The sex disparity in the 30-day survival after the initiation of Impella support was evaluated. Results: A total of 924 patients (median age 73 years; 21% female) were included. Female patients were older and had a smaller physiques than male patients (p &lt; 0.05 for both). Female sex was significantly associated with a higher 30-day mortality after adjustment for four other potential confounders with a hazard ratio of 1.365 (95% confidence interval 1.026\u20131.816, p = 0.0324). In the female cohort, patients who received Impella prior to revascularization (N = 138) had a greater survival rate compared to those who received Impella after revascularization (68.1% versus 44.8%, p = 0.0015). Conclusions: Among the patients with AMI-CS who received Impella support and underwent revascularization, female sex was independently associated with a lower 30-day survival. For female patients, early initiation of Impella support prior to revascularization may improve their clinical outcomes.<\/jats:p>","DOI":"10.3390\/medicina59071208","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:25:21Z","timestamp":1687911921000},"page":"1208","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Sex-Related Differences in Short-Term Prognosis in Patients with Acute Myocardial Infarction-Related Cardiogenic Shock Receiving Impella Support in Japan: From the J-PVAD Registry"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9604-5603","authenticated-orcid":false,"given":"Makiko","family":"Nakamura","sequence":"first","affiliation":[{"name":"Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7294-7637","authenticated-orcid":false,"given":"Teruhiko","family":"Imamura","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9747-2511","authenticated-orcid":false,"given":"Hiroshi","family":"Ueno","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Kinugawa","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J-PVAD","family":"Investigators","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Toyama, 2630 Sugitani Toyama, Toyama 930-0194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/S0735-1097(00)00879-2","article-title":"Cardiogenic shock complicating acute myocardial infarction--etiologies, management and outcome: A report from the SHOCK Trial Registry. Should we emergently revascularize Occluded Coronaries for cardiogenic shock?","volume":"36","author":"Hochman","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1001\/jama.2021.18323","article-title":"Cardiogenic Shock after Acute Myocardial Infarction: A Review","volume":"326","author":"Samsky","year":"2021","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/joic.12298","article-title":"Women with Cardiogenic Shock Derive Greater Benefit from Early Mechanical Circulatory Support: An Update from the cVAD Registry","volume":"29","author":"Joseph","year":"2016","journal-title":"J. Interv. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1016\/j.mayocp.2020.01.043","article-title":"Sex and Gender Disparities in the Management and Outcomes of Acute Myocardial Infarction-Cardiogenic Shock in Older Adults","volume":"95","author":"Vallabhajosyula","year":"2020","journal-title":"Mayo Clin. Proc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11883-020-0828-0","article-title":"Mechanical Circulatory Support: A Comprehensive Review with a Focus on Women","volume":"22","author":"Alasnag","year":"2020","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.cjco.2020.06.001","article-title":"Sex Disparities in the Use and Outcomes of Temporary Mechanical Circulatory Support for Acute Myocardial Infarction-Cardiogenic Shock","volume":"2","author":"Vallabhajosyula","year":"2020","journal-title":"CJC Open"},{"key":"ref_7","first-page":"588","article-title":"Short-Term Outcomes of Impella Support in Japanese Patients with Cardiogenic Shock Due to Acute Myocardial Infarction\u2014Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD)","volume":"87","author":"Ikeda","year":"2023","journal-title":"Circ. J. Off. J. Jpn. Circ. Soc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jjcc.2019.12.003","article-title":"Current indication and practical management of percutaneous left ventricular assist device support therapy in Japan","volume":"75","author":"Nakamura","year":"2019","journal-title":"J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1002\/ccd.28456","article-title":"Patient size parameters to guide use of the Impella device in pediatric patients","volume":"94","author":"Morray","year":"2019","journal-title":"Catheter. Cardiovasc. Interv. Off. J. Soc. Card. Angiogr. Interv."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s10047-022-01328-1","article-title":"Three-year experience of catheter-based micro-axial left ventricular assist device, Impella, in Japanese patients: The first interim analysis of Japan registry for percutaneous ventricular assist device (J-PVAD)","volume":"26","author":"Toda","year":"2023","journal-title":"J. Artif. Organs Off. J. Jpn. Soc. Artif. Organs"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Imamura, S., Miyata, M., Tagata, K., Yokomine, T., Ohmure, K., Kawasoe, M., Otsuji, H., Chaen, H., Oketani, N., and Ogawa, M. (J. Cardiol., 2023). Prognostic predictors in patients with cardiopulmonary arrest: A novel equation for evaluating the 30-day mortality, J. Cardiol., in press.","DOI":"10.1016\/j.jjcc.2023.01.006"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1001\/jama.285.2.190","article-title":"One-year survival following early revascularization for cardiogenic shock","volume":"285","author":"Hochman","year":"2001","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.cardfail.2021.10.006","article-title":"Sex Differences in Heart Failure","volume":"28","author":"Lala","year":"2022","journal-title":"J. Card. Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s11897-023-00593-2","article-title":"Sex Differences in Acute Heart Failure Management: Is There a Gap in Treatment Quality?","volume":"20","year":"2023","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1002\/ehf2.13300","article-title":"Sex differences in congestive markers in patients hospitalized for acute heart failure","volume":"8","author":"Espersen","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e005050","DOI":"10.1161\/CIRCINTERVENTIONS.117.005050","article-title":"Acute Mitral Regurgitation Secondary to Papillary Muscle Tear: Is Transcatheter Edge-to-Edge Mitral Valve Repair a New Paradigm?","volume":"10","author":"Valle","year":"2017","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00392-014-0789-9","article-title":"Percutaneous mitral valve repair as rescue procedure after post myocardial infarction papillary muscle rupture and acute cardiogenic shock","volume":"104","author":"Horstkotte","year":"2015","journal-title":"Clin. Res. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1093\/eurheartj\/ehaa071","article-title":"The association of long-term outcome and biological sex in patients with acute heart failure from different geographic regions","volume":"41","author":"Akiyama","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e13526","DOI":"10.1111\/eci.13526","article-title":"Sex bias in admission to tertiary-care centres for acute myocardial infarction and cardiogenic shock","volume":"51","author":"Sambola","year":"2021","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1002\/ehf2.13303","article-title":"Sex differences in patients with cardiogenic shock","volume":"8","author":"Yan","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Collado-Lled\u00f3, E., Lla\u00f3, I., Rivas-Lasarte, M., Gonz\u00e1lez-Fern\u00e1ndez, V., Noriega, F.J., Hern\u00e1ndez-Perez, F.J., Alegre, O., Sionis, A., Lid\u00f3n, R.M., and Viana-Tejedor, A. (2020). Clinical picture, management and risk stratification in patients with cardiogenic shock: Does gender matter?. BMC Cardiovasc. Disord., 20.","DOI":"10.1186\/s12872-020-01467-4"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e008537","DOI":"10.1161\/CIRCINTERVENTIONS.119.008537","article-title":"Sex-Specific Management in Patients with Acute Myocardial Infarction and Cardiogenic Shock: A Substudy of the CULPRIT-SHOCK Trial","volume":"13","author":"Zeymer","year":"2020","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/j.jtcvs.2020.12.044","article-title":"Sex differences in patients with cardiogenic shock requiring extracorporeal membrane oxygenation","volume":"164","author":"Wang","year":"2022","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1177\/2048872617745790","article-title":"Gender difference with the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: From pVAD Working Group","volume":"8","author":"Doshi","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.atherosclerosis.2023.05.007","article-title":"Sex disparities in guideline-recommended therapies and outcomes after ST-elevation myocardial infarction in a contemporary nationwide cohort of patients over an eight-year period","volume":"375","author":"Kuehnemund","year":"2023","journal-title":"Atherosclerosis"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1002\/ccd.28509","article-title":"Sex-related difference in the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: Insight from the cVAD registry","volume":"96","author":"Alraies","year":"2020","journal-title":"Catheter. Cardiovasc. Interv. Off. J. Soc. Card. Angiogr. Interv."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1208\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:02:05Z","timestamp":1760126525000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,27]]},"references-count":26,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["medicina59071208"],"URL":"https:\/\/doi.org\/10.3390\/medicina59071208","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,27]]}}}