在ST段升高心肌梗塞后的不良左心室重塑和临床结果的性别差异
Albert Alonso Tello1,2,3, Antonia Sambola1,2, Filippa Valente1,2
1Department of Cardiology, Departament de Medicina, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autónoma de Barcelona, P° Vall d'Hebron, 119-129, Barcelona 08035, Spain.
European heart journal. Cardiovascular Imaging
|February 10, 2025
概括
性别对ST升高心肌梗塞后的左心室重塑没有不利影响. 在女性中,较高的重大心脏不良事件与风险因素有关,而不是重塑.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 临床结果研究研究
背景情况:
- 在ST升高后心肌梗塞 (STEMI) 的左心室逆转型 (LVR) 中基于性别的差异仍然不清楚.
- 现有研究提出了关于LVR的性别差异和STEMI后的临床结果的相互矛盾的结果.
研究的目的:
- 研究STEMI后不良LVR的基于性别的差异.
- 确定这些基于性别的差异对主要不良心脏事件 (MACE) 的影响.
主要方法:
- 使用心血管磁共振 (CMR) 来评估基线和STEMI后6个月的LVR.
- 包括接受初级穿皮冠状动脉干预 (PCI) 的患者.
- 随访患者的主要不良心脏事件 (MACE) 中位数为6.94年.
主要成果:
- 没有发现女性性别和不良LVR (OR:0.80;95%CI,0.39-1.64) 之间有显著的关联.
- 在女性中,MACE的发病率较高 (22.6%对15.4%;P=0.017).
- 在调整心血管风险因素和并发症后,女性性别与MACE没有独立相关 (HR:1.21;95% CI,0.81-1.81).
结论:
- 在STEMI后的女性中,更高的MACE率归因于心血管风险因素和并发症的增加.
- 不良的LVR似乎不是STEMI后基于性别的结果差异的主要驱动因素.
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