冠状动脉支架后的长期结果,根据早产史
Moa Pehrson1, Andreas Edsfeldt2,3,4, Giovanna Sarno5
1Perinatal and Cardiovascular Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
JACC. Advances
|June 28, 2024
概括
过早分娩的病史增加了冠状动脉支架后妇女主要不良心血管事件 (MACE) 和死亡率的风险. 这一发现强调了早产史作为评估女性心血管风险的关键因素.
科学领域:
- 心血管医学 心血管医学
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
背景情况:
- 与男性相比,女性在穿皮冠状动脉干预后面临更高的重大不良心血管事件 (MACE) 风险.
- 过早分娩史是已知的冠状动脉疾病的女性特异性风险因素,但其干预后的影响尚不清楚.
研究的目的:
- 调查女性初始冠状动脉支架后早产史和MACE之间的关联.
- 在这个患者队列中分析与早产史相关的死亡风险.
主要方法:
- 分析了一组全国范围的5,766名瑞典妇女 (≤65岁) 接受了他们的第一个冠状动脉支架 (2006-2017).
- 使用比例危险回归来调整混因素,并评估早产史和MACE (>30天后造血栓) 之间的联系.
主要成果:
- 在平均3.7年的随访期间,20.8%的女性经历了MACE. 过早分娩史 (16.7%的队列) 与MACE风险 (aHR 1.19) 和死亡率 (aHR 1.38) 的增加有关.
- 这些关联甚至在排除了患有妊娠相关高血压疾病或糖尿病的妇女之后也持续存在.
- 与晚期早产相比,早产早产的MACE风险较低.
结论:
- 在女性首次冠状动脉支架后,早产史与较差的结果有关,包括更高的MACE和死亡率.
- 过早分娩史应被认为是妇女心血管疾病的二次预防的重要风险因素.
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