急性A型剖析的呈现,管理和临床结果:性别是否重要?
Frederike Meccanici1, Carlijn G E Thijssen1,2, Arjen L Gökalp3
1Department of Congenital Cardiology, Erasmus MC, Rotterdam, The Netherlands.
JTCVS open
|May 1, 2025
概括
这项研究揭示了女性急性A型大动脉剖析的明显临床表现,这些女性年龄较大,并有更多的并发症. 虽然短期结果相似,但女性的长期存活率较差,需要进一步研究风险因素.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 大动脉疾病 大动脉疾病
背景情况:
- 急性A型大动脉解剖 (AD-A) 在呈现,管理和结果方面表现出已知的男性和女性差异.
- 关于AD-A中这些基于性别的差异的可靠数据有限.
- 这项研究旨在调查这些差异在大型队列中.
研究的目的:
- 为了比较男性和女性之间急性A型大动脉解剖 (AD-A) 的临床表现,管理策略以及短期和长期结果.
- 确定AD-A患者死亡的性别特异性风险因素.
- 评估与性别相关的长期生存率和再干预率.
主要方法:
- 在2007年至2017年间,在四个转诊中心对889名被诊断为AD-A的成年患者进行了回顾性分析.
- 收集基线人口统计数据,心血管相关疾病,临床表现细节 (低血压,吸管,恶心),手术特征和随访数据.
- 统计分析以比较性别之间的结果,包括短期和10年生存率以及重新干预率.
主要成果:
- 女性在呈现时年龄大得多,并且更频繁地呈现心血管并发症,严重的低血压,吸管和恶心.
- 在女性 (18.5%) 和男性 (21.2%) 之间,短期死亡率相似.
- 与男性 (62.8%) 相比,女性的整体10年生存率较低 (50.1%),尽管在多变量校正后并不显著. 长期再干预率是相似的.
结论:
- 对于患有AD-A的男性和女性,存在不同的临床概况,女性年龄较大,并患有更多的并发症.
- 虽然治疗和短期死亡率相似,但女性的长期存活率较差.
- 对性别特异性风险分层和管理进行进一步的研究是有必要的,以改善AD-A的结果.
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