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性别相关贫血导致 60 岁以下 ST 段抬高型心肌梗死患者结局存在差异。

Sex-Related Anemia Contributes to Disparities in Outcome of Patients Younger Than 60 Years with ST-Elevation Myocardial Infarction.

机构信息

1 Division of Internal Medicine, Department of Cardiology and Angiology, University Medical Center Maribor , Maribor, Slovenia .

2 Herzzentrum Leipzig , Leipzig, Germany .

出版信息

J Womens Health (Larchmt). 2018 Jun;27(6):755-760. doi: 10.1089/jwh.2017.6644. Epub 2018 Jan 29.

DOI:10.1089/jwh.2017.6644
PMID:29377747
Abstract

BACKGROUND

Younger women with ST-segment elevation myocardial infarction (STEMI) have a worse outcome than their age-matched male peers. Our aim was to assess whether there are sex-based differences in anemia on admission, and if they are associated with the outcome of patients with STEMI younger than 60 years undergoing primary percutaneous coronary intervention (PCI).

MATERIALS AND METHODS

Data of 2095 STEMI patients, 804 of whom were younger than 60 years, were analyzed. Data were analyzed using descriptive statistics. All-cause 30-day and 2-year mortality were documented.

RESULTS

Women had a higher prevalence of anemia compared with men on admission (34.4% in women vs. 20.0% in men; p < 0.0001). The 30-day mortality was similar in both groups (5.5% in women vs. 3.3% in men; p = 0.17). Anemia on admission, age, cardiogenic shock, and diabetes predicted higher 30-day mortality. Two-year mortality was higher in women (9.8% in women vs. 4.8% in men; p = 0.023). Anemia on admission, age, cardiogenic shock, and diabetes were identified as independent predictors of 2-year mortality. Sex was not associated with 30-day or 2-year mortality.

CONCLUSIONS

We found sex-based differences in anemia on admission in STEMI patients younger than 60 years. Anemia, but not sex, was linked to 30-day and 2-year mortality. Anemia on admission in women younger than 60 years may help to explain the increased 2-year sex-related mortality in younger STEMI patients undergoing primary PCI.

摘要

背景

年轻女性 ST 段抬高型心肌梗死(STEMI)患者的预后比同龄男性患者差。我们的目的是评估年轻 STEMI 患者(年龄<60 岁)入院时是否存在贫血性别差异,以及这种差异是否与接受直接经皮冠状动脉介入治疗(PCI)的患者的预后有关。

材料和方法

分析了 2095 例 STEMI 患者的数据,其中 804 例年龄<60 岁。采用描述性统计方法进行数据分析。记录全因 30 天和 2 年死亡率。

结果

与男性相比,女性入院时贫血的发生率更高(女性 34.4%,男性 20.0%;p<0.0001)。两组 30 天死亡率相似(女性 5.5%,男性 3.3%;p=0.17)。入院时贫血、年龄、心源性休克和糖尿病预测 30 天死亡率更高。女性 2 年死亡率更高(女性 9.8%,男性 4.8%;p=0.023)。入院时贫血、年龄、心源性休克和糖尿病被确定为 2 年死亡率的独立预测因素。性别与 30 天或 2 年死亡率无关。

结论

我们发现,年龄<60 岁的 STEMI 患者入院时存在贫血性别差异。贫血,而不是性别,与 30 天和 2 年死亡率有关。年龄<60 岁的女性入院时贫血可能有助于解释接受直接 PCI 的年轻 STEMI 患者 2 年相关性别死亡率升高的原因。

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