在接受心脏移植的患者中,临床特征和临床结果的性别差异
Christoph Kondziella1, Nina Fluschnik1,2, Jessica Weimann1
1Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
ESC heart failure
|June 20, 2023
概括
性影响心脏移植结果. 男人面临更高的风险心脏异体移植血管病变和恶性瘤移植后,而死亡率和移植失败率在两性之间是相似的. 个性化护理至关重要.
科学领域:
- 心脏病学 心脏病学
- 移植医学 移植医学
- 健康中的性别差异
背景情况:
- 性别对心脏移植 (HTx) 选择和结果的影响尚未完全理解.
- 调查基于性别的差异对于优化患者护理和改善HTx后的长期结果至关重要.
研究的目的:
- 确定移植前特征的性别特异性.
- 评估心脏移植后结果的基于性别的变化,包括死亡率,移植失败,心脏合移植血管病变 (CAV) 和恶性瘤.
主要方法:
- 来自器官采购和移植网络 (1995-2019) 的大量队列 (49,200) 的分析.
- 临床特征的逻辑回归和结果的多变量考克斯回归 (死亡率,移植失败,CAV,恶性病变).
主要成果:
- 男性的缺血性心肌病和心血管风险因素的发病率较高;女性的恶性瘤较少.
- 男人需要更多的重症监护室支持,通风和VAD支持.
- 移植后,男性的CAV和恶性瘤风险增加,在所有原因的死亡率,心血管死亡率或移植失败方面没有性别差异.
结论:
- 在CAV和恶性瘤的移植前形状和HTx后风险方面存在显著的性别差异.
- 这些发现凸显了基于性别的量身定制的心脏移植后管理策略的必要性.
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