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Heart:房颤患者临床表现与1年预后的性别差异如何?

2017-02-23 xing.T MedSci原创

由此可见,女性房颤患者症状更多,但不太可能接受侵入性的节律控制治疗如心脏电复律或消融。需要进一步的研究来确认这些差异对女性房颤患者产生不利影响。

近日,在心脏病领域权威杂志Heart上发表了一篇研究文章,研究人员旨在评估房颤患者在临床表现、治疗和预后上的性别差异。

该研究纳入了6412例房颤患者,39.7%为女性,这些患者来自于血栓栓塞事件的预防-房颤欧洲注册中心,研究人员评估了房颤患者症状、危险因素、治疗和1年不良预后发生率的性别差异。

研究人员发现男性房颤患者整体要比女性房颤患者年轻(平均值±标准差:70.1±10.7岁 vs. 74.1±9.7岁,P<0.0001)。与男性相比,女性患者更频繁地出现至少一个房颤相关症状(女性为95.4%,男性为89.8%,P<0.0001)。两者口服抗凝药较为相似,服用非维生素K拮抗剂口服抗凝药的增加女性从5.9%到12.6%,男性从6.2%到12.6%,两者均有P<0.0001。

男性患者更常接受心脏电复律和消融治疗(分别为20.6%和6.3%),相比于女性(分别为14.9%和3.3%,P<0.0001)。1年后,女性发生经年龄调整和国家调整的冠状动脉血运重建几率要低65%(比值比为0.35;95%可信区间为0.22-0.56),急性冠脉综合征要低40%(比值比为0.60;0.38-0.93)和心衰要低20%(比值比为0.80;0.68-0.96)。1年卒中/短暂性脑缺血发作/动脉血栓栓塞和大出血事件的性别差异无统计学意义。

由此可见,女性房颤患者症状更多,但不太可能接受侵入性的节律控制治疗如心脏电复律或消融。需要进一步的研究来确认这些差异对女性房颤患者产生不利影响。

原始出处:

Renate B Schnabel,et al. Gender differences in clinical presentation and 1-year outcomes in atrial fibrillation. Heart. 2017. http://dx.doi.org/10.1136/heartjnl-2016-310406

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    2017-02-25 zhaojie88
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    2017-02-25 slcumt
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    2017-02-24 忠诚向上

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