探索与植入式心脏转换器-除器植入后的长期存活相关的性别和临床因素:一项为期10年的队列研究
Rebeca Lorca1,2,3,4,5, María Salgado1,4, Cristina Helguera1,4
1Área del Corazón, Hospital Universitario Central Asturias, 33011 Oviedo, Spain.
Journal of clinical medicine
|February 13, 2026
概括
接受植入式心脏变压器 (ICD) 的女性的未调整死亡率低于男性. 然而,性别并不是调整后生存的独立预测因素,这表明临床因素解释了生存差异.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 临床研究 临床研究
背景情况:
- 植入式心脏转换器-除器 (ICD) 结果的性别差异需要进一步调查.
- 在ICD植入后,男性和女性之间长期生存差异的现实数据有限.
- 了解性别特定的死亡率对于优化患者护理至关重要.
研究的目的:
- 评估一大群ICD接受者的性别特定死亡率.
- 评估男性和女性在ICD植入后的相对生存差异.
- 确定影响ICD患者长期结果的因素.
主要方法:
- 对1091名连续ICD患者 (2015-2025) 的回顾性队列研究.
- 数据收集包括人口统计,设备指示和死亡率.
- 使用Ederer II方法估计的相对存活率;用于基于性别的死亡率分析的Cox比例危险模型.
主要成果:
- 女性有较低的未调整全因死亡率 (18.0%对20.6%) 和更好的基线特征 (更高的LVEF,更少的缺血性心肌病).
- 多变量分析显示,性别不是死亡率的独立预测因素 (HR 0.81).
- 长期相对存活率显示,ICD携带者,特别是男性的死亡率负担很大,与普通人群相比,死亡率明显高.
结论:
- 与一般人群相比,患有ICD的女性的未调整死亡率和过度死亡率较低.
- 观察到的生存差异似乎主要是由临床形状和并发症负担驱动的,而不是性别本身.
- 进一步的研究应该集中在考虑这些因素的个性化风险分层.
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