接受左主干穿皮冠状动脉干预治疗稳定心痛的患者的性别差异:来自国家注册表的数据
Warkaa Shamkhani1,2,3, Zafraan Zathar3, Sophia Khattak3
1Keele Cardiovascular Research Group, Centre for Prognosis Research, Institutes of Applied Clinical Science and Primary Care and Health Sciences Keele University Stoke-on-Trent United Kingdom.
Journal of the American Heart Association
|November 15, 2024
概括
接受左主冠状动脉 (LMCA) 皮肤冠状动脉干预 (PCI) 治疗稳定性心痛的妇女面临更高的死亡率和重大出血风险,尽管并发症较少. 建议采用适合性别的方法,以改善LMCA PCI的结果.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 健康 结果 研究 研究 结果
背景情况:
- 通过皮肤进行冠状动脉干预 (PCI) 治疗左侧冠状动脉疾病 (LMCA) 在稳定性心痛中正在增加.
- 关于LMCA PCI后临床结果的基于性别的差异存在有限的数据.
- 评估性别特异性趋势和结果对于优化患者护理至关重要.
研究的目的:
- 为了评估基于性别的趋势和临床结果的差异,在接受LMCA PCI的稳定性胸痛患者中.
- 确定可能导致男女成绩差异的潜在因素.
- 为改善LMCA PCI结果提供性别定制策略的信息.
主要方法:
- 对接受LMCA PCI的稳定心痛患者的英国国家PCI注册数据 (2006-2022) 的回顾性分析.
- 住院死亡率,主要出血,主要心血管和大脑事件是主要和次要结局.
- 使用多变量逻辑回归来确定结果的调整几率比率,控制患者的特征.
主要成果:
- 在24,271次LMCA PCI手术中,22.7%是在女性中进行的,这些女性年龄较大,并具有较低的并发症负担.
- 女性在住院患者死亡率 (aOR,1.63) 和重大出血 (aOR,2.07) 的调整后几率显著更高.
- 虽然主要的心血管和大脑事件在女性中较高,但这种差异在统计学上并不显著 (aOR,1.27).
结论:
- 接受LMCA PCI的女性的结果更差,包括死亡率增加和严重出血,即使伴随疾病较少.
- 年龄,血管内成像使用和血管接入策略可能会影响基于性别的结果差异.
- 为了改善接受LMCA PCI的女性的临床结果,需要采用适合性别的方法.
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