从LEADER注册表的左心室尾关闭-分析的长期结果中的性别差异
Aviad Rotholz1,2, Hagai Itach2, Roi Ferman3
1Cardiology Department, Beilinson Hospital, Rabin Medical Center, Ze'ev Jabotinsky St 39, Petah Tikva 4941492, Israel.
Journal of clinical medicine
|February 27, 2026
概括
穿皮左心房尾关闭 (LAAC) 是心房动 (AF) 患者的一种安全的中风预防方法. 这项研究没有发现AF患者在LAAC的程序或长期结果中存在显著的性别差异.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 在心房的管理管理.
背景情况:
- 穿皮左心房尾关闭 (LAAC) 为心房 (AF) 患有高出血风险的患者提供了口服抗凝剂 (OAC) 的替代方案.
- 以前的研究表明,在接受LAAC的妇女中,术前并发症的发生率更高,但长期结局数据仍然不一致.
研究的目的:
- 在LAAC后的临床结果中调查潜在的基于性别的差异.
- 评估LAAC作为中风预防策略在现实世界AF患者群体中的有效性和安全性.
主要方法:
- 在四个以色列医疗中心 (2010年至2023年) 进行LAAC的407名连续AF患者的分析 (LEADER注册表).
- 在男性和女性患者之间比较基线特征,程序数据和临床结果.
- 主要终点包括缺血性中风/全身血栓塞 (有效性) 和1年死亡率,并发症或重大出血 (安全性) 的复合.
主要成果:
- 在主要的术前并发症中没有观察到任何显著的性别差异 (男性7.0%,女性4.9%,p=0.51).
- 在1年的随访中,疗效终点 (缺血性中风/全身栓塞:2.6%) 和安全终点 (复合:19.2%,大出血:8.9%,全因死亡率:9.3%) 在性别之间可比 (所有p>0.1).
- 设备植入成功率在男性和女性中都超过了99%.
结论:
- 与之前的一些报道相反,这项现实世界的多中心研究发现,在LAAC后,在术前或1年后的结果中没有显著的性别差异.
- 在男性和女性中,LAAC的安全性和有效性相似,支持其作为AF患者中风预防策略的性别独立作用.
- 这些发现强化了LAAC在降低高出血风险AF患者中风风险方面的价值,无论性别如何.
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