在急性冠状动脉综合征之后的心力衰竭的性别差异
Edina Cenko1, Olivia Manfrini1,2, Jinsung Yoon3
1Laboratory of Epidemiological and Clinical Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
JACC. Advances
|June 28, 2024
概括
患有急性冠状动脉综合征 (ACS) 的女性面临更高的死亡率,特别是ST段升高心肌梗塞 (STEMI). 急性心力衰竭 (HF) 显著增加了两性死亡风险,女性在STEMI期间更容易患HF.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 基于性别的医学
背景情况:
- 关于患有急性冠状动脉综合征 (ACS) 的女性的结果,存在相互矛盾的报道.
- 了解ACS的性别差异对于改善患者护理至关重要.
- 急性心力衰竭 (HF) 是影响 ACS 结果的关键并发症.
研究的目的:
- 调查 ACS 和急性 HF 患者30天死亡率的性别差异.
- 分析性别,急性HF呈现和ACS中的死亡率之间的关系.
- 确定导致男性和女性ACS患者结果差异的因素.
主要方法:
- 对国际急性冠状动脉综合征调查-档案 (ISACS-档案) 数据库的回顾性分析.
- 包括87,812名患者,按ACS类型分层:STEMI和非ST段升高ACS (NSTE-ACS).
- 使用逆倾向权衡来比较30天死亡率和性别之间的急性HF呈现,与相互作用的测试.
主要成果:
- 在STEMI和NSTE-ACS表现中,女性的总死亡率高于男性.
- 与男性相比,患有STEMI的女性的死亡风险比率显著更高 (RR:1.65).
- 患有STEMI的女性中急性HF更为普遍 (RR:1.24),这种差异在NSTE-ACS中没有观察到.
结论:
- 患有ACS的女性的死亡率高于男性.
- 在呈现时急性HF的存在会增加所有患者的死亡风险.
- 患有STEMI的女性急性HF的可能性增加可能部分解释基于性别的死亡率差异,强调需要性别特异性风险分层.
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