Verheugt Carianne L, Uiterwaal Cuno S P M, van der Velde Enno T, Meijboom Folkert J, Pieper Petronella G, Vliegen Hubert W, van Dijk Arie P J, Bouma Berto J, Grobbee Diederick E, Mulder Barbara J M
Department of Cardiology, Academic Medical Center, Amsterdam, Netherlands.
Circulation. 2008 Jul 1;118(1):26-32. doi: 10.1161/CIRCULATIONAHA.107.758086. Epub 2008 Jun 16.
Gender differences in prognosis have frequently been reported in cardiovascular disease but less so in congenital heart disease. We investigated whether gender is associated with outcome in adult patients with congenital heart disease.
From the CONgenital CORvitia (CONCOR) national registry for adults with congenital heart disease, 7414 patients were identified. All outcomes before entry into the registry and during subsequent follow-up were recorded, and differences between men and women were analyzed with the underlying congenital heart defect taken into account. Median age at the end of follow-up was 35 years (range, 17 to 91 years); 49.8% were female. No gender difference in mortality was found. Women had a 33% higher risk of pulmonary hypertension (odds ratio [OR]=1.33; 95% CI, 1.07 to 1.65; P=0.01), a 33% lower risk of aortic outcomes (OR=0.67; 95% CI, 0.50 to 0.90; P=0.007), a 47% lower risk of endocarditis (OR=0.53; 95% CI, 0.40 to 0.70; P<0.001), and a 55% lower risk of an implantable cardioverter-defibrillator (OR=0.45; 95% CI, 0.26 to 0.80; P=0.006). Furthermore, the risk of arrhythmias appeared to be lower in women (OR=0.88; 95% CI, 0.77 to 1.02; P=0.08).
The risk of several major cardiac outcomes in adult patients with congenital heart disease appears to vary by gender.
心血管疾病预后的性别差异已有诸多报道，但先天性心脏病方面的报道较少。我们研究了性别是否与成年先天性心脏病患者的预后相关。
从先天性心脏病成人患者的全国性注册库“先天性心脏病队列研究（CONCOR）”中，识别出7414例患者。记录了入组前及后续随访期间的所有结局，并在考虑潜在先天性心脏缺陷的情况下分析了男女之间的差异。随访结束时的中位年龄为35岁（范围17至91岁）；女性占49.8%。未发现死亡率存在性别差异。女性患肺动脉高压的风险高33%（比值比[OR]=1.33；95%置信区间[CI]，1.07至1.65；P=0.01），主动脉相关结局的风险低33%（OR=0.67；95%CI，0.50至0.90；P=0.007），心内膜炎的风险低47%（OR=0.53；95%CI，0.40至0.70；P<0.001），植入式心脏复律除颤器的风险低55%（OR=0.45；95%CI，0.26至0.80；P=0.006）。此外，女性心律失常的风险似乎较低（OR=0.88；95%CI，0.77至1.02；P=0.08）。
成年先天性心脏病患者的几种主要心脏结局风险似乎因性别而异。
