新发生的心血管疾病的临床表现在男性和女性之间是否存在差异？
Does the clinical spectrum of incident cardiovascular disease differ between men and women?
机构信息
University of Kuopio, Department of Medicine, Finland
University of Kuopio, Department of Medicine, Finland.
出版信息
Eur J Prev Cardiol. 2014 Aug;21(8):964-71. doi: 10.1177/2047487313482284. Epub 2013 Mar 12.
BACKGROUND
Cardiovascular diseases (CVDs) are the main cause of death and disability in the western world. Women are known to be older at the time of first CVD event, but the main types of CVD events and their relative importance and differences compared with men are not well known. Our aim was to evaluate gender differences in the clinical presentation of incident major adverse cardiovascular events (MACE).
DESIGN
A population-based study with prospective follow-up.
METHODS
We used data from the population-based National FINRISK Surveys from years 1992, 1997, 2002 and 2007. People with prevalent cardiovascular disease were excluded. In total, 27,897 participants (53, 2% women) aged 25-74 years were included in the analyses.
RESULTS
During the 292,316 person-years of follow-up, 2573 MACE were identified. MACE were more frequent in men than women (1318; 95% CI 1252-1388 in men vs. 736; 686-789 in women). Men had four times more fatal coronary heart disease (CHD) events (149; 126-174 vs. 39; 28-53) and three times more non-fatal CHD events (512; 471-555 vs. 164; 141-189) than women. Stroke incidence was higher in men than women (268; 238-301 vs. 169; 145-195). Heart failure (HF) incidence did not differ between genders. The relative proportions of MACE categories differed substantially between genders: HF was the most common type among women (50% vs. 30% in men), whereas the most common type among men was CHD (50% vs. 28% in women).
CONCLUSIONS
Incident MACE were more common in men than women. HF was the dominant type of MACE in women, whereas CHD dominated in men.
背景
心血管疾病（CVDs）是西方世界主要的死亡和残疾原因。已知女性首次发生 CVD 事件的年龄更大，但 CVD 事件的主要类型及其与男性相比的重要性和差异尚不清楚。我们的目的是评估女性在新发主要不良心血管事件（MACE）的临床表现中的性别差异。
设计
一项基于人群的前瞻性随访研究。
方法
我们使用了来自 1992 年、1997 年、2002 年和 2007 年基于人群的全国 FINRISK 调查的数据。排除了有心血管疾病既往史的患者。共纳入了 27897 名年龄在 25-74 岁的参与者（53%为女性）进行分析。
结果
在 292316 人年的随访期间，共确定了 2573 例 MACE。男性 MACE 发生率高于女性（男性 1318 例[95%CI 1252-1388]，女性 736 例[686-789]）。男性致命性冠心病（CHD）事件的发生率是女性的四倍（149 例[126-174] vs. 39 例[28-53]），非致命性 CHD 事件的发生率是女性的三倍（512 例[471-555] vs. 164 例[141-189]）。男性中风发生率高于女性（268 例[238-301] vs. 169 例[145-195]）。两性心力衰竭（HF）的发生率无差异。MACE 类别的相对比例在性别之间有很大差异：HF 是女性最常见的类型（50%，男性为 30%），而男性最常见的类型是 CHD（50%，女性为 28%）。
结论
新发 MACE 在男性中比女性更常见。HF 是女性 MACE 的主要类型，而 CHD 则是男性 MACE 的主要类型。
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