Am J Cardiol. 2026 May 27:S0002-9149(26)00364-4. doi: 10.1016/j.amjcard.2026.05.023. Online ahead of print.
ABSTRACT
Myocarditis-associated cardiogenic shock (MACS) is associated with significant morbidity and mortality, yet sex-based differences in outcomes remain poorly characterized. We conducted a retrospective cohort study using the TriNetX Research Network, a federated electronic health records platform aggregating de-identified data from 99 US health care organizations. Adult patients with concurrent diagnosis of myocarditis and cardiogenic shock from January 1, 2012, to December 31, 2024, were included. After 1:1 propensity score matching, 1,452 males and 1,452 females were identified with balanced baseline characteristics. The risk of all-cause mortality within 6 months of the index date was lower among males compared with females (20.1% vs. 24.0%; HR: 0.82 [95% CI: 0.70-0.96]; P=0.01). Males had higher rates of AKI (44.0% vs. 38.8%; HR: 1.18 [95% CI: 1.05-1.67]; P=0.004), while rates of new-onset atrial fibrillation/flutter, ventricular tachyarrhythmias, cardiac arrest, and mechanical circulatory support use were similar between sexes. In conclusion, in this large real-world cohort of patients with MACS, female sex was associated with higher 6-month mortality despite lower AKI rates and similar arrhythmia burden and MCS use, suggesting that patient sex may be an important prognostic variable warranting further prospective investigation.
PMID:42208717 | DOI:10.1016/j.amjcard.2026.05.023