最近心房細動と診断された高齢の患者の脳卒中リスクにおける性別差異
Meytal Avgil Tsadok1, Cynthia A Jackevicius, Elham Rahme
1Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.
JAMA
|May 10, 2012
まとめ
動脈動 (AF) を患っている女性は,同様のワーファリンの使用でも,男性よりも脳卒中のリスクが高い. この研究では,女性の脳卒中リスクが高く,特に75歳以上の女性が脳卒中のリスクが高いことが判明しました.
科学分野:
- 心臓病学 心臓病学
- ゲリアトリクス ゲリアトリクス
- 公衆衛生は公衆衛生である.
背景:
- 心房細動 (AF) は脳卒中リスクを大幅に増加させる.
- AFの女性は,男性に比べて脳卒中のリスクが高くなります.
- ワルファリンの治療不足を含む可能性のあるこの格差の理由は,完全に理解されていません.
研究 の 目的:
- ウォルファリンの使用量とAFの高齢男性と女性の脳卒中のリスクを比較する.
- AF患者における男女間の脳卒中リスクにおける集団レベルの差異を調査する.
主な方法:
- カナダのケベック州 (1998年~2007年) の行政データを利用した人口ベースのコホート研究.
- 新たに診断されたAFで入院した65歳以上の患者も含まれていた.
- 病院退院,医師,処方薬の請求に関するデータをリンクした.
主要な成果:
- この研究では39,398人の男性と44,115人の女性が参加し,女性は高齢で,CHADSのスコアが高かった.
- ワルファリン処方箋の充填率は同様のもので,女性ではわずかに高い割合 (60.6%対58.2%) であった.
- 女性の脳卒中リスク (aHR,1.14;P < .001) は,特に75歳以上で,かなり高かった.
結論:
- 最近AFと診断された高齢の女性は,男性よりも脳卒中のリスクが高くなります.
- この増加したリスクは,ワーファリンの使用に関係なく持続し,他の要因が寄与していることを示唆しています.
- この発見は,AF患者の脳卒中リスクにおける性別による重大な格差を強調しています.
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