导航心力衰竭:在指导方针导向的医学治疗组合中揭示性别差异
Ahmet Celik1, Anil Sahin2, Naim Ata3
1Department of Cardiology, Faculty of Medicine, Mersin University, Mersin, Türkiye.
The American journal of cardiology
|January 24, 2024
概括
这项研究揭示了心力衰竭 (HF) 管理和结果的显著性别差异. 虽然/葡萄糖携带载体2抑制剂 (SGLT2i) 对两性都有好处,但狄戈辛却对两性都有好处.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 主要心力衰竭 (HF) 试验往往代表女性不足,限制了对性别特异性的理解.
- 现有的研究不足以解决人口统计学,并发症,生物标志物,药物和性别之间的结果差异在HF管理中.
- 对于分析高频率的性别差异,以优化治疗策略至关重要.
研究的目的:
- 调查和呈现心力衰竭 (HF) 管理中的与性别相关的差异.
- 为了比较男性和女性HF患者之间的人口特征,并发症,心脏生物标志物,处方药物和治疗结果.
- 评估特定治疗组合的有效性,包括/葡萄糖共传输体2抑制剂 (SGLT2i),以减少所有原因的死亡率.
主要方法:
- 分析了来自土耳其卫生部国家电子数据库 (2016-2022) 的匿名数据.
- 这项分析包括了2,501,231名心力衰竭 (HF) 的成年患者.
- 考克斯回归模型被用来评估通过特定的治疗组合来评估所有原因死亡的相对风险降低.
主要成果:
- 女性患者年龄较大,糖尿病,贫血,心房动,焦虑和缺血性中风的发病率较高;男性患者先前心肌梗塞,失脂症,慢性肺炎和CKD的发病率较高.
- 男性患者接受了更多的氨酸 - 血管新生素阿尔多斯特抑制剂,β-阻断剂,MRAs,SGLT2i和伊瓦布拉丁,并且CRT/ICD植入率更高;女性接受了更多的循环利尿剂,狄戈辛和铁性碳酸盐.
- 所有原因的死亡率和住院率在男性患者中更高. 所有治疗组合,包括SGLT2i,在两性中都降低了全因死亡率. 在住院的女性患者中,添加digoxin显示出性别特异性的益处.
结论:
- 在心力衰竭 (HF) 患者的并发症和治疗反应中存在显著的性别差异.
- 考虑到高频的这些性别特异性变化,定制的管理策略至关重要.
- /葡萄糖共运输体2抑制剂 (SGLT2i) 在不同性别之间表现出一致的益处,而狄戈辛对死亡率的影响在住院后有所不同.
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