长期心力衰竭预后中的性别差异:一个全面的元分析
Weida Qiu1, Wenbin Wang1, Shiping Wu1
1Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China.
European journal of preventive cardiology
|August 5, 2024
概括
患有心力衰竭 (HF) 的女性的长期预后比男性更好,死亡率和住院的风险较低. 这种生存益处在慢性HF病例和随机对照试验的参与者中更为显著.
科学领域:
- 心脏病学 心脏病学
- 临床流行病学临床流行病学
- 医学中的性别差异.
背景情况:
- 关于心力衰竭 (HF) 预后的性别差异是有争议的,对长期结果的综合数据有限.
- 了解这些差异对于个性化高频管理至关重要.
研究的目的:
- 在心力衰竭的长期预后中全面分析性别差异.
- 为了研究年龄,HF过程,射出分数,区域,研究期,设计和随访持续时间如何影响这些性别差异.
主要方法:
- 从1990年1月到2024年3月发表的研究的系统审查和元分析.
- 包括94项研究 (96个队列) 与706,247名参与者,分析所有原因死亡率 (ACM),心血管死亡率 (CVM) 和HF (HHF) 的住院病例.
- 随机效应元分析以计算聚合危险比率 (HR) 和95%置信区间 (CI).
主要成果:
- 与男性相比,女性HF患者的ACM (HR 0.83),CVM (HR 0.84),HHF (HR 0.94) 和复合终点风险明显较低.
- 女性的死亡益处在慢性HF (随访时间>2年) 和随机对照试验中更为明显.
- 亚组分析表明HF过程和研究设计的显著相互作用 (P <0.05).
结论:
- 患有心力衰竭的女性通常比男性有更好的长期预后,其特点是死亡和住院的风险降低.
- 尽管在临床试验中代表性较低,但女性表现出生存优势,尽管可能不如现实世界中那么明显.
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