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JACC:使用SAPIEN 3瓣膜经导管主动脉瓣置换术的性别特异性结局

2018-01-03 xiangting MedSci原创

这项研究在TAVR试验中未发现生存率或卒中存在明显的性别特异性差异。

这项研究的目的是为了确定使用SAPIEN 3瓣膜进行经导管主动脉瓣置换术的中危患者的性别特异性结局。

在不能手术和接受早期球囊扩张瓣膜经导管主动脉瓣置换术(TAVR)的高危患者中,女性与男性的生存率存在差异。使用新一代瓣膜和低危患者中是否也存在性别特异性结局差异尚不清楚。

PARTNER(主动脉经导管瓣膜置换术)II期S3试验包括患有严重症状性主动脉瓣狭窄的高危(HR)(胸外科医师协会风险评分> 8%或心脏团队测定)和中危(IR)(胸外科医师协会风险评分4%-8%或心脏团队测定)患者,这些患者接受使用SAPIEN 3瓣膜的TAVR治疗。按性别比较30天和1年的患者特征和临床结局。

2013年10月至2014年12月期间,共有1,661名患者入选,583名为HR(338名男性,245名女性)和1078名IR(666名男性,412名女性)。在这2个队列中,女性比男性更容易虚弱(22% vs 13%; p <0.001),但是出现肾功能不全、冠状动脉疾病、房颤或慢性阻塞性肺病等合并症的可能性更低。女性更多接受≤23毫米的瓣膜(74.1% vs 11.1%; p <0.001),并且接受29毫米瓣膜的更少(1.4% vs 35.1%; p <0.001)。在联合队列中与男性相比,30天(2.0% vs 1.2%; p = 0.20)或1年(9.3% vs 10.2%; p = 0.59)女性的死亡率没有差异。30天或1年的致残性卒中或任何卒中没有差异; 然而,女性30天时小卒中的发生率较高(2.1% vs 0.7%; p = 0.01)。女性性别与大血管并发症升高有关(7.9% vs 4.4%; p = 0.003),但与中重度瓣周返流无关。值得注意的是,在HR和IR队列分层分析中获得了关于性别特异性结局的类似结果。

这项研究在TAVR试验中未发现生存率或卒中存在明显的性别特异性差异。这反映了入选患者人口学的变化,更多尺寸可供选择的新一代瓣膜的应用以及更准确的瓣膜测量技术。

原始出处:
Molly Szerlip, et al. Sex-Specific Outcomes of Transcatheter Aortic Valve Replacement With the SAPIEN 3 Valve. JACC:Cardiovascular Interventions. January 2018. 

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time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510116, encodeId=d699151011644, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=)]
    2018-09-29 lizhou0204
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time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510116, encodeId=d699151011644, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=)]
    2018-07-24 hbwxf
  4. 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createdName=jinweidong, createdTime=Wed Mar 14 12:14:00 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853895, encodeId=9c22185389524, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Jul 24 14:14:00 CST 2018, time=2018-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742462, encodeId=5fcc1e424622a, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Thu Aug 30 10:14:00 CST 2018, time=2018-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898178, encodeId=080718981e82c, content=<a href='/topic/show?id=8904158e9e7' target=_blank style='color:#2F92EE;'>#SAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15879, encryptionId=8904158e9e7, topicName=SAP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30f5146, createdName=zz70, createdTime=Mon Dec 03 01:14:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325659, encodeId=7c14132565953, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332491, encodeId=13c21332491fa, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367111, encodeId=4996136e11183, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415260, encodeId=8a75141526064, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510116, encodeId=d699151011644, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=)]
    2018-08-30 yxch48
  5. [GetPortalCommentsPageByObjectIdResponse(id=2049938, encodeId=a96d204993890, content=<a href='/topic/show?id=b1b315883e1' target=_blank style='color:#2F92EE;'>#Sapien#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15883, encryptionId=b1b315883e1, topicName=Sapien)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d01326, createdName=lizhou0204, createdTime=Sat Sep 29 12:14:00 CST 2018, time=2018-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1899185, encodeId=99771899185af, content=<a href='/topic/show?id=6f746e94170' target=_blank style='color:#2F92EE;'>#特异性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67941, encryptionId=6f746e94170, topicName=特异性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, 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time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510116, encodeId=d699151011644, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=)]
    2018-12-03 zz70
  6. [GetPortalCommentsPageByObjectIdResponse(id=2049938, encodeId=a96d204993890, content=<a href='/topic/show?id=b1b315883e1' target=_blank style='color:#2F92EE;'>#Sapien#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15883, encryptionId=b1b315883e1, topicName=Sapien)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d01326, createdName=lizhou0204, createdTime=Sat Sep 29 12:14:00 CST 2018, time=2018-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1899185, encodeId=99771899185af, content=<a href='/topic/show?id=6f746e94170' target=_blank style='color:#2F92EE;'>#特异性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67941, encryptionId=6f746e94170, topicName=特异性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc7a157, 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time=2018-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510116, encodeId=d699151011644, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Fri Jan 05 06:14:00 CST 2018, time=2018-01-05, status=1, ipAttribution=)]
  7. 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  9. 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    2018-01-05 lsj631

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