在患有大动脉狭窄和减少射出分数的患者中,性别特定的结果
Amélie Paquin1, Kathia Abdoun2, David Bienjonetti-Boudreau2
1Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, and Department of Medicine, Faculty of Medicine, Université Laval, Québec City, Quebec, Canada. Electronic address: https://twitter.com/paquin_amelie.
The Canadian journal of cardiology
|July 18, 2025
概括
患有大动脉狭窄和射出分数减少的妇女接受门置换的可能性较低,并面临更高的死亡风险. 两性同样受益于大动脉置换,但差异仍然存在.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 临床研究 临床研究
背景情况:
- 与男性相比,患有大动脉狭窄症 (AS) 的女性的死亡率更高,对大动脉置换 (AVR) 的转诊率更低.
- 性别对AS患者减少左心室喷射分数 (LVEF) 的结果的影响尚不清楚.
研究的目的:
- 为了比较患有AS和减少LVEF的女性和男性之间所有原因死亡的风险.
- 调查该患者群体中AVR转诊和结果的基于性别的差异.
主要方法:
- 对827名中度AS和LVEF<50%的患者进行了回顾性研究 (2005-2018).
- 对AVR率和全因死亡率的政府注册数据的分析.
- 调整模型用于并发症,LVEF,AS严重程度和AVR作为时间依赖的共变量.
主要成果:
- 妇女占队列的38%,LVEF的中位数为37%.
- 调整后的分析显示,女性接受AVR的可能性较小 (OR=0.58,p=0.007).
- 保守治疗的妇女死亡风险较高 (HR=1.39,p=0.02),在AVR存活益处方面没有性别相互作用.
结论:
- 在降低LVEF的AS患者中,与男性相比,女性在保守治疗时面临较低的AVR率和更高的死亡率.
- 大动脉置换为两性提供了类似的生存益处.
- 需要进一步的研究来识别和解决导致这些基于性别的差异的潜在偏见.
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