稳定性胸痛的管理和临床结果的性别差异
Caroline Daly1, Felicity Clemens, Jose L Lopez Sendon
1Royal Brompton Hospital, Sydney St, London SW3 6 NP, UK. caroline.daly@imperial.ac.uk.
Circulation
|February 2, 2006
概括
患有稳定性胸痛的女性接受的诊断测试和基于证据的治疗较少,导致结果更差. 这项研究强调了心血管护理中的重大性别偏见,影响了预后.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 稳定性胸痛影响了大量患者,有可能导致基于性别的护理差异.
- 了解这些差异对于改善患者治疗结果至关重要.
研究的目的:
- 调查性别对稳定性心痛的诊断工作和管理的影响.
- 评估一年后临床结果的性别差异.
主要方法:
- 分析了欧洲心脏调查数据,包括3779名患者 (42%为女性).
- 两性之间的调查率 (运动心电图,冠状动脉图) 和治疗模式 (抗血小板药物,他类药物,再血管) 的比较.
- 随访1年以评估临床结果,包括死亡或非致命的心肌梗塞.
主要成果:
- 妇女不太可能接受运动心电图和冠状动脉血管造影.
- 抗血小板药物和他类药物治疗在女性中未得到充分利用,即使是确诊的冠状动脉疾病.
- 确诊冠状动脉疾病的女性的复血管化率较低,患心血管不良事件的可能性是女性的两倍.
结论:
- 在研究和治疗稳定性胸痛方面存在显著的性别偏见.
- 这种偏见有助于稳定性 angina 的妇女较差的临床结果.
- 解决心血管保健中的性别差异对于改善预后至关重要.
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