在最近被诊断为心房的老年患者中,中风风险的性别差异
Meytal Avgil Tsadok1, Cynthia A Jackevicius, Elham Rahme
1Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.
JAMA
|May 10, 2012
概括
患有心房的女性比男性面临更高的中风风险,即使使用类似的华法林. 这项研究发现,女性患中风的风险更高,尤其是75岁及以上的女性.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 心房动 (AF) 显著增加了中风风险.
- 与男性相比,患有AF的女性的中风风险更高.
- 这种差异的原因,可能包括华法林治疗不足,尚未完全理解.
研究的目的:
- 为了比较华法林的利用率和随后的中风风险,老年男性和女性与AF.
- 调查AF患者中性别之间的中风风险在人口水平上的差异.
主要方法:
- 一项基于人口的队列研究,利用加拿大北克省 (1998-2007) 的行政数据.
- 包括65岁以上的住院患者,新诊断的AF.
- 相关的医院出院,医生和处方药索赔数据.
主要成果:
- 这项研究包括39398名男性和44115名女性;女性年龄较大,CHADS分数较高.
- 华法林处方填充率相似,女性的填充率略高 (60.6%与58.2%相比).
- 女性患中风的原始和调整风险明显高 (aHR,1.14,P<.001),尤其是75岁以上的女性.
结论:
- 最近被诊断出AF的老年女性面临比男性更大的中风风险.
- 这种增加的风险无论华法林的使用如何,都会持续存在,这表明其他因素也有所贡献.
- 这些发现突出了AF患者中脑卒中风险的性别差异.
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