女性性别对冠状动脉疾病和外周动脉疾病的不同影响。

Differential effect of female gender on coronary artery disease and peripheral artery disease.

作者信息

van Lennep H W O Roeters, Westerveld H T, Zwinderman A H, van Lennep J E Roeters, Slot H Bruins, Erkelens D W, van der Wall E E

出版信息

Neth Heart J. 2002 Dec;10(12):500-505.

PMID:25696054

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2499819/

Abstract

BACKGROUND

Women are relatively protected against coronary artery disease (CAD). Whether female gender has a similar protective influence on the development of peripheral artery disease (PAD) has not been extensively investigated and was the main subject of our study.

METHODS

We analysed 2707 consecutive patients (2008 men and 699 women) who underwent a first diagnostic coronary angiography for suspicion of CAD and 2367 consecutive patients (1426 men and 941 women) who underwent a first ankle arm index measurement because of suspicion of PAD.

RESULTS

We found that a positive diagnosis for CAD and PAD was more common in men compared with women (80.7% vs 57.9%, p<0.0001 and 68.0% vs 60.7%, p<0.0001). Once CAD or PAD was established, severity of disease was similar for men and women, which pleads against a referral bias. Women had a reduced risk of CAD after adjustment for risk factors (odds ratio [OR] 0.32, 95% confidence interval [CI] 0.22-0.46, p<0.0001), but not of PAD (OR 0.82, 95% CI 0.66-1.03, p=NS). In patients with CAD and in those with PAD, women were older, more often had diabetes and hypertension, while men were more likely to be current smokers. Hypertension, smoking and diabetes were associated with CAD in both men and women. Current smoking was associated with PAD in men and women. Hypertension and diabetes were associated with PAD in women but not in men.

CONCLUSION

After adjustment for risk factors, the female protection for CAD seems to less present for PAD.

摘要

背景

女性相对不易患冠状动脉疾病（CAD）。女性性别对外周动脉疾病（PAD）的发展是否具有类似的保护作用尚未得到广泛研究，这是我们研究的主要课题。

方法

我们分析了2707例因疑似CAD而接受首次诊断性冠状动脉造影的连续患者（2008例男性和699例女性），以及2367例因疑似PAD而接受首次踝臂指数测量的连续患者（1426例男性和941例女性）。

结果

我们发现，与女性相比，CAD和PAD的阳性诊断在男性中更为常见（80.7%对57.9%，p<0.0001；68.0%对60.7%，p<0.0001）。一旦确诊CAD或PAD，男性和女性的疾病严重程度相似，这排除了转诊偏倚。在调整风险因素后，女性患CAD的风险降低（优势比[OR]0.32，95%置信区间[CI]0.22 - 0.46，p<0.0001），但患PAD的风险未降低（OR 0.82，95%CI 0.66 - 1.03，p=无统计学意义）。在CAD患者和PAD患者中，女性年龄更大，更常患有糖尿病和高血压，而男性更可能是当前吸烟者。高血压、吸烟和糖尿病在男性和女性中均与CAD相关。当前吸烟在男性和女性中均与PAD相关。高血压和糖尿病在女性中与PAD相关，但在男性中不相关。