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Circ:Cardiovasc Inte:PCI治疗后病因特异性死亡率的性别差异

2018-03-18 xiangting MedSci原创

性PCI治疗后死亡率较高是由于非心脏性原因引起的。

经皮冠脉介入治疗后女性的全因死亡率较高。这是由于年龄较大,合并症负担还是性别特异性因素尚不清楚。

研究人员回顾性评估了PCI治疗后3个时间段(1991-1997,1998-2005和2006-2012)的病因特异性长期死亡率。死因是通过电话访问、病历和死亡证明确定的。对病因特异性死亡率进行了竞争风险分析。1991至2012年间,共有6847名女性和16 280名男性PCI治疗后存活。女性年龄较大(平均值±SD:69.4±12 vs.64.8±11.7岁; P <0.001),并发症较多(平均值±SD:Charlson指数2.1±2.1 vs.1.9±2.1; P <0.001)。在3个时间段中,男性和女性5年时的心脏死亡率有所下降(女性相对减少26%,男性17%,趋势P <0.001)。尽管在所有时期女性的全因死亡率高于男性,但超额死亡率是由非心脏死亡产生的。在当代,只有少数人死于心脏病(女性为33.8%,男性为38.0%)。调整后,没有证据表明心脏性或非心脏性死亡率存在性别特异性风险。最常见的死因在女性是慢性病和心力衰竭(5年累积死亡率5.4%和3.9%),但男性为癌症和心肌梗死/猝死(5.4%和4.3%)。

女性PCI治疗后死亡率较高是由于非心脏性原因引起的。这是由基线年龄和合并症引起的,而不是额外的性别特异性因素。这些发现对性别特异性临床治疗和试验设计具有影响。

原始出处:
Claire E. Raphael, et al. Sex Differences in Long-Term Cause-Specific Mortality After Percutaneous Coronary Intervention. Circ:Cardiovasc Inte. 16 March 2018.

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