Jankowski Piotr, Kawecka-Jaszcz Kalina, Czarnecka Danuta, Bryniarski Leszek, Brzozowska-Kiszka Małgorzata, Kieć-Wilk Beata, Dymek Grzegorz, Kopacz Ewa, Królikowski Tadeusz, Dudek Dariusz
1st Department of Cardiology, Collegium Medicum Jagiellonian University, Cracow, Poland.
Kardiol Pol. 2007 May;65(5):475-84; discussion 485.
Although gender-related differences in cardiovascular risk in patients with acute coronary syndromes have been investigated several times in Poland, there are few data on the effects of gender on management of patients with stable ischaemic heart disease (IHD). In addition, available data on the prognosis in this condition in men and women are also scarce.
To assess gender-related differences in treatment and event-free survival in patients with IHD undergoing non-emergency coronary angiography.
960 consecutive patients with IHD undergoing coronary angiography were included. Study end points were ascertained over 4.5-year follow-up in 925 patients, of whom 187 were women and 738 were men. The primary end-point consisted of cardiovascular death, myocardial infarction, stroke, cardiac arrest, PCI, CABG or heart transplantation.
Female gender was independently related to higher prescription rate of beta-blockers [odds ratio 1.89 (95% CI 1.08-3.29)], ACE inhibitors [1.47 (1.01-2.16)] and calcium antagonists [1.65 (1.08-2.53)] at the time of coronary angiography. On the other hand, female gender was not independently related to the probability of PCI [1.01 (0.69-1.49)] or CABG [0.91 (0.57-1.48)]. We did not find any gender-related difference in the risk of the primary end point [hazard ratio 0.94 (95% CI 0.67-1.34)] or the three predefined secondary end points.
Female gender was independently related to a higher prescription rate of beta-blockers, ACE inhibitors and calcium antagonists. No gender-related revascularisation was found in respect of myocardial revascularisation. Gender was not an independent factor affecting event-free survival in patients with IHD undergoing non-emergency coronary angiography.
尽管波兰已多次研究急性冠脉综合征患者心血管风险的性别差异,但关于性别对稳定型缺血性心脏病(IHD)患者管理的影响的数据却很少。此外,关于这种情况下男性和女性预后的现有数据也很匮乏。
评估接受非急诊冠状动脉造影的IHD患者在治疗和无事件生存方面的性别差异。
纳入960例连续接受冠状动脉造影的IHD患者。在925例患者中进行了4.5年的随访以确定研究终点,其中187例为女性,738例为男性。主要终点包括心血管死亡、心肌梗死、中风、心脏骤停、经皮冠状动脉介入治疗(PCI)、冠状动脉旁路移植术(CABG)或心脏移植。
在冠状动脉造影时,女性与β受体阻滞剂[比值比1.89(95%可信区间1.08 - 3.29)]、血管紧张素转换酶(ACE)抑制剂[1.47(1.01 - 2.16)]和钙拮抗剂[1.65(1.08 - 2.53)]的较高处方率独立相关。另一方面,女性与PCI[1.01(0.69 - 1.49)]或CABG[0.91(0.57 - 1.48)]的可能性无独立相关性。我们未发现主要终点风险[风险比0.94(95%可信区间0.67 - 1.34)]或三个预定义次要终点存在任何性别差异。
女性与β受体阻滞剂、ACE抑制剂和钙拮抗剂的较高处方率独立相关。在心肌血运重建方面未发现性别相关的血运重建差异。性别不是影响接受非急诊冠状动脉造影的IHD患者无事件生存的独立因素。