心力衰竭管理和结果的性别差异:来自法国-DataHF队列的见解
Guillaume Baudry1,2,3, Ouarda Pereira4,5, François Roubille6
1Université de Lorraine, INSERM, Centre d'Investigation Clinique Plurithématique 1433, Inserm U1116, CHRU de Nancy, Nancy, France.
European journal of heart failure
|June 20, 2025
概括
患有心力衰竭 (HF) 的女性表现出更好的预后调整,但接受的指导方针导向的医疗治疗和心脏病随访较少. 改善女性HF患者获得专业护理的机会可以降低死亡率.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 健康差异 在健康上的差异
背景情况:
- 性别显著影响心力衰竭 (HF) 的预后,但基于性别的管理和结果的差异在现实世界的人口中未得到充分研究.
- 了解这些差异对于优化跨不同患者群体的HF护理至关重要.
研究的目的:
- 评估心力衰竭预后和管理中的与性别相关的差异.
- 分析治疗模式和结果的性别差异,在一个大规模的全国性队列中.
主要方法:
- 利用了法国-数据HF队列,包括超过655,000名被诊断患有HF的患者.
- 应用逆概率权重 (IPW) 来调整基线差异.
- 评估所有原因死亡率 (ACM) 和HF住院治疗作为主要和次要结局,使用Cox比例危险模型.
主要成果:
- 女性 (48%的队列) 的1年ACM为16.8%,男性为15.1%.
- 经过调整后的分析显示,女性接受的氨酸-血管增生素系统抑制剂较少,每年心脏病随访也较少.
- 女性的ACM调整风险降低了21%,复合结局风险降低了15%.
- 增加心脏病随访与两性中ACM风险降低有关.
结论:
- 尽管预后更好地调整,但患有HF的女性在指导方针导向的医疗治疗和心脏病随访方面存在差异.
- 有针对性的干预措施,以提高女性HF患者获得专业护理的机会,有必要改善结果并降低死亡率.
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