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在患有功能衰竭的患者心血管结果的性别差异
Silvi Shah1, Annette L Christianson2, Karthikeyan Meganathan2
1Division of Nephrology and Hypertension, Department of Internal Medicine University of Cincinnati Cincinnati OH USA.
Journal of the American Heart Association
|May 3, 2024
概括
接受透析的女性面临心力衰竭和中风的更高风险,但与男性相比,心血管原因和全因死亡的死亡率较低. 这突显了功能衰竭患者心血管结果的性别差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 流行病学 流行病学
- 基于性别的医学是基于性别的.
背景情况:
- 心血管疾病 (CVD) 是衰竭患者的主要死亡原因.
- 与一般人群相比,这些患者患心血管事件的风险增加了10到20倍.
研究的目的:
- 在开始透析的患者中调查基于性别的心血管事件风险,心血管死亡和全因死亡率的差异.
- 分析性别与特定心血管结果之间的关联,包括急性冠状动脉综合征,心力衰竭和中风.
主要方法:
- 在2005年至2014年期间使用美国脏数据系统 (USRDS) 与相关的医疗保险索赔对508,822名开始透析的患者进行评估.
- 确定心血管事件 (急性冠状动脉综合征,心力衰竭,中风) 的住院率.
- 利用调整的时间到事件模型来检查性别与结果的关联.
主要成果:
- 妇女占研究队列的44.7% (平均年龄70±12岁).
- 整体心血管事件发生率为每1000人年232,女性 (248) 比男性 (219) 高.
- 妇女患心血管事件的风险增加了14% (HR 1.14),心力衰竭风险增加了16% (HR 1.16),中风风险增加了31% (HR 1.31),但急性冠状动脉综合征风险没有差异 (HR 1.01).
- 相反,与男性相比,女性心血管死亡风险 (HR 0.89),所有原因死亡风险 (HR 0.96) 较低.
结论:
- 在透析患者中,女性患心力衰竭和中风的风险比男性高.
- 尽管事件发生率较高,但女性对心血管死亡率和全因死亡率的调整风险较低.
- 调查结果强调,在末期病患者群体内,心血管结果和死亡率的性别差异显著.
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