糖尿病患者结局的性别差异。

Gender differences in outcome in patients with diabetes mellitus.

机构信息

Cardiology Department, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d'Hebron, 119-129, Barcelona, Spain.

Department of Nuclear Medicine, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.

出版信息

J Nucl Cardiol. 2022 Feb;29(1):72-82. doi: 10.1007/s12350-020-02195-0. Epub 2020 May 26.

DOI:10.1007/s12350-020-02195-0

PMID:32458331

Abstract

BACKGROUND

Diabetes mellitus is an independent risk factor in the development of coronary artery disease (CAD), myocardial infarction (MI), and cardiac death (CD). The major adverse cardiac events (MACEs) between men and women in diabetic patients stratified by CAD (previous MI and/or coronary revascularization, CR) were analyzed.

METHODS AND RESULTS

A cohort of 1327 consecutive diabetic patients (age 66.5 ± 9 years) underwent gated SPECT (single-photon emission computed tomography). During a mean follow-up of 4.7 ± 2.2 years post gated SPECT, MACEs (non-fatal MI, CD, and late CR) were evaluated according to gender stratified by CAD. Among diabetic patients without known CAD (N = 731), men had more MACEs (sHR 1.9;95%CI 1.2-3.2) than women. Among diabetic patients with known CAD (N = 596), there was no difference in MACEs in diabetic men and women (sHR 1.15;95%CI 0.73-1.8). Diabetic women with known CAD (n = 143) were the group with the highest risk (sHR 1.7; P = .041) for MACEs (4.5% MACEs/year, [95%CI 3.1%-6.4%]), compared to the remaining diabetic patients (N = 1184) (3% MACEs/year, [95%CI 2.6%-3.5%]).

CONCLUSIONS

The prognosis of diabetic patients for MACEs is different in men and women stratified by CAD. The worst prognosis for MACEs occurs in women with known CAD.

摘要

背景

糖尿病是冠心病（CAD）、心肌梗死（MI）和心脏死亡（CD）发展的独立危险因素。对经 CAD（既往 MI 和/或冠状动脉血运重建，CR）分层的糖尿病患者进行了男女之间主要不良心脏事件（MACEs）的比较分析。

方法和结果

对 1327 例连续的糖尿病患者（年龄 66.5±9 岁）进行门控 SPECT（单光子发射计算机断层扫描）检查。在门控 SPECT 后平均随访 4.7±2.2 年期间，根据 CAD 分层的性别评估了 MACEs（非致死性 MI、CD 和晚期 CR）。在无已知 CAD 的糖尿病患者中（N=731），男性的 MACEs 发生率更高（sHR 1.9；95%CI 1.2-3.2）。在已知 CAD 的糖尿病患者中（N=596），男性和女性的 MACEs 发生率无差异（sHR 1.15；95%CI 0.73-1.8）。患有已知 CAD 的糖尿病女性（n=143）是 MACEs 风险最高的人群（sHR 1.7；P=0.041）（4.5%的 MACEs/年，[95%CI 3.1%-6.4%]），与其余糖尿病患者（N=1184）（3%的 MACEs/年，[95%CI 2.6%-3.5%]）相比。