女性和男性进行冠状动脉支架的预后因素和结果的差异
J Mehilli1, A Kastrati, J Dirschinger
1Deutsches Herzzentrum, Lazarettstr 36, 80636 Munich, Germany.
JAMA
|October 12, 2000
概括
冠状动脉疾病 (CAD) 患者接受冠状动脉支架的女性在一年后的结果与男性相似. 然而,女性面临更高的早期风险,糖尿病是主要的预后因素,与男性不同的是,年龄更为关键.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 基于性别的医学
背景情况:
- 传统上,冠状动脉疾病 (CAD) 的管理侧重于男性特异性风险.
- 与男性相比,患有CAD的女性可能会经历更糟糕的干预后结果.
- 冠状动脉支架对基于性别的结果的影响需要进一步调查.
研究的目的:
- 调查预后因素的基于性别的差异.
- 为了比较男性和女性冠状动脉支架后的早期和晚期结果.
主要方法:
- 开始的队列研究包括1001名女性和3263名患有症状的CAD的男性.
- 冠状动脉支架安置是在1992年5月至1998年12月之间进行的.
- 结合事件的死亡率和非致命的心肌梗塞被评估在30天和1年.
主要成果:
- 女性年龄较大,糖尿病,高血压和高胆固醇血症的发病率高于男性.
- 妇女的早期死亡或心肌梗塞风险增加 (3.1% vs 1.8%在30天;调整HR2.02).
- 一年后,两性结果相似 (6.0%对5.8%;调整后HR为1.06),糖尿病是女性的关键因素,男性的年龄是关键因素.
结论:
- 冠状动脉支架后的一年后的结果对于患有CAD的女性和男性是相似的.
- 在基线特征,临床过程和预后因素方面存在明显的性别差异.
- 了解这些差异对于女性个性化CAD管理至关重要.
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