在患有上升性大动脉扩张患者的长期结果中,基于性别的差异
Mohammed Abusafia1, Shada Jadam1, Vidyasagar Kalahasti1
1Aortic Center, Heart Vascular Thoracic Institute Cleveland Clinic Cleveland OH USA.
Journal of the American Heart Association
|December 3, 2025
概括
胸部上升性大关节病 (AA) 的妇女经历了更糟糕的长期存活,尽管伴随性疾病较少,手术率更高. 这些发现表明,在AA手术建议中需要性别特定的门.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 医学研究 医学研究
背景情况:
- 胸部上升性动脉损伤 (AA) 通常是无症状的,并偶尔被诊断出来.
- 当AA变为动脉瘤时,通常建议进行手术替换.
- 这项研究调查了AA患者特征和结果的基于性别的差异.
研究的目的:
- 分析胸部上升性大关节病 (AA) 患者的基于性别的特征和长期结果.
- 为了比较男性和女性与AA之间的并发症,大动脉测量和外科手术干预率.
- 根据性别确定影响AA患者死亡率和存活率的因素.
主要方法:
- 对14244名未修复的AA (≥4厘米) 患者的分析,通过心声回声学诊断 (2010-2023年).
- 排除患有急性大动脉解剖/破裂的患者.
- 收集基线数据,包括高度索引的大动脉测量,并记录AA手术和剖析/破裂事件. 进行了考克斯比例危险和卡普兰-梅尔生存分析.
主要成果:
- 与男性相比,女性年龄较大,并发病率较少,但与男性相比,高度指数化的大动脉测量更高.
- 尽管女性的外科手术率较高 (28.2%对25.6%),但她们的长期存活率较差 (14.2%对11.2%).
- 女性性别独立地与更高的死亡率相关 (HR,1.14),而大动脉手术改善了生存率 (HR,0.81). 大动脉直径小于5厘米的未经手术的妇女占死亡和剖析/断裂的很大比例.
结论:
- 与男性相比,患有AA的女性的长期生存结果较差,即使伴随疾病较少,手术干预率更高.
- 这些发现表明,目前的AA手术值可能对女性来说不是最佳的.
- 考虑AA手术的性别特定值是有必要的,以改善患者的治疗结果.
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