在隔离严重的大动脉狭窄症的大动脉干预后临床结果的性别差异
Teresa Sevilla1,2, Noemí Ramos3, Manuel Carnero4
1Cardiology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain.
Journal of clinical medicine
|November 25, 2023
概括
患有大动脉狭窄症 (AS) 的女性患有更严重的疾病,并且更频繁地接受大动脉干预 (AVI). 尽管AVI后心力衰竭再住院率较高,但长期死亡率与男性相似.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 临床医学 临床医学
背景情况:
- 确立了大动脉狭窄 (AS) 的病理生理学和临床表现的基于性别的差异.
- 了解这些差异在主动脉干预后 (AVI) 对于优化患者护理至关重要.
研究的目的:
- 调查性差异的临床表现,干预和AVI后的结果,在症状严重的AS患者.
- 确定女性性别是否是AVI后不良结果的独立预测因素.
主要方法:
- 在两个中心进行AVI的451名症状严重AS患者的观察性研究.
- 收集和分析了临床表现,干预类型和死亡率的数据,平均随访时间为5年.
主要成果:
- 女性在呈现时年龄较大,平均梯度较高,大动脉膜面积较低,肺动脉压力较高.
- 女性更频繁地接受穿皮AVI. 在5年的随访中,女性心力衰竭住院率较高 (23%vs9%).
- 女性性别是心力衰竭住院的独立预测因素 (HR 1.16-4.22). 性别之间没有观察到心血管或整体死亡率的显著差异.
结论:
- 患有严重AS的妇女在更晚的阶段出现,并在AVI后经历更高的心力衰竭再住院率.
- 尽管存在这些差异,但AVI后的长期死亡率在男性和女性之间是可比的.
- 为了管理AVI后女性心力衰竭风险,可能需要考虑性别.
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