改变冠状动脉手术患者的临床特征. 男人和女人之间的差异
W S Weintraub1, N K Wenger, E L Jones
1Division of Cardiology, Emory University Hospital, Atlanta, GA 30322.
Circulation
|November 1, 1993
概括
冠状动脉旁路移植手术 (CABG) 结果显示,两性死亡率都在增加,女性由于年龄,并发症和疾病严重程度而面临不成比例的更高风险.
科学领域:
- 心血管外科心血管外科
- 医学成果研究研究成果
- 健康差异 在健康上的差异
背景情况:
- 在男性和女性之间,冠状动脉旁路移植手术 (CABG) 的相对有效性存在不确定性.
- 对不良结果的风险因素的增加需要重新评估CABG疗效中基于性别的差异.
- 这项研究旨在分析不断变化的患者特征及其对两性CABG结果的影响.
研究的目的:
- 检查接受CABG的患者临床概况的时间变化.
- 确定这些变化如何影响男性与女性的CABG结果.
- 确定影响CABG结果的特定性别风险因素.
主要方法:
- 来自埃莫里大学医院的临床数据库的分析,包括1974年至1991年间接受CABG的13368名患者.
- 患者分为四个时间段 (1974-1979,1980-1983,1984-1987,1988-1991) 的阶层.
- 预期数据收集和计算机化数据库输入,并对死亡相关的多变量分析.
主要成果:
- 与男性相比,接受CABG的女性年龄较大,糖尿病发病率较高.
- 妇女 (3.8%) 的住院死亡率明显高于男性 (1.6%).
- 多变量分析确定女性性别,年龄较大,糖尿病和更严重的冠状动脉疾病与死亡相关,随着时间的推移,死亡率在女性中增加得更快.
结论:
- CABG患者人口正在老龄化,医院死亡风险因素的患病率更高.
- 妇女在CABG后的死亡率较高,仅部分由临床变量解释.
- 妇女的死亡风险增加与持续的年龄差异,新出现的手术和糖尿病的更高率,以及近年来严重冠状动脉疾病的更大患病率有关.
更多相关视频
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
相关概念视频
01:30Coronary Artery Disease I: Introduction
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
01:30Coronary Artery Disease III: Clinical Manifestations
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
01:26Coronary Artery Disease IV: Preventive Measures
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
01:27Coronary Artery Disease V: Interprofessional Care
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...