针对女性冠状动脉疾病的再输液和再血管化策略
1Harvard-Thorndike Laboratory, Beth Israel Hospital, Boston, MA 02215.
JAMA
|October 14, 1992
概括
冠状动脉疾病的结果因性别而异. 虽然女性从血栓溶解和血管造形中受益,但冠状动脉旁路手术的结果可能更多取决于风险因素而不是性别. 对于女性患者来说,需要独特的方法.
科学领域:
- 心脏病学 心脏病学
- 心血管疾病 心血管疾病
- 性别特异医学性别特异医学
背景情况:
- 冠心病 (CHD) 是美国女性的主要死亡原因.
- 在心血管疾病的表现,治疗和结果方面存在显著的性别差异.
- 有限的随机试验集中在女性治疗心脏病的治疗策略上.
研究的目的:
- 审查冠状动脉再血管化和再输血疗法的与性别相关的结果.
- 为针对心脏病患者的妇女制定量身定制的临床方法提供信息.
- 突出在心血管医学中需要性别特定的研究.
主要方法:
- 使用MEDLINE对英语文章 (1970-1992) 进行了全面的文献搜索.
- 包括血栓溶解的随机对照试验和关于女性血管造形术和冠状动脉旁路移植 (CABG) 的重要文章.
- 两个独立的审稿人进行数据提取,以便进行平衡的审稿.
主要成果:
- 针对急性心肌梗塞的血栓溶解显示了两性死亡率的好处,在女性中可能不那么明显.
- 血管整形和较新的干预措施产生更高的手术发病率,但在妇女中可比或更好的长期结果.
- 妇女可能会经历CABG的较高死亡率,尽管结果受到冠状动脉解剖学和手术前因素的影响,而不是性别.
结论:
- 心血管疾病进展和治疗反应的性别差异需要针对女性的个性化临床策略.
- 非常需要随机试验,充分招收女性,以解决心脏病的性别问题.
- 进一步的研究对于优化女性心血管保健至关重要.
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