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不稳定型心绞痛患者的性别和年龄差异:一项单中心回顾性研究。

Sex and Age Differences in Patients With Unstable Angina Pectoris: A Single-Center Retrospective Study.

机构信息

Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China; Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

Am J Med Sci. 2020 Sep;360(3):268-278. doi: 10.1016/j.amjms.2020.05.020. Epub 2020 May 20.

Abstract

BACKGROUND

Sex and age may affect the pathogenesis of coronary heart disease, such as cardiovascular risk factors, treatment and prognosis, but this information is not well known.

METHODS

This was a single-center retrospective cohort study. Patients with unstable angina pectoris between January 2013 and June 2018 were included and stratified into 4 age groups (<55, 55-64, 65-74 and ≥75 years). The cardiovascular risk factors profile, treatment and in-hospital prognosis differences by sex and age were explored.

RESULTS

This study included 5,908 patients (2,198 women). The women were older than the men (mean age 67 vs. 62 years). Approximately 2 of 3 patients had ≥3 cardiovascular risk factors. Men were more likely to be smokers, and women had a higher level of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Hypertension, diabetes and chronic kidney disease were more frequent in women ≥ 65 years old than in similarly aged men. Men and women less than 65 years of age had more frequent family history of coronary heart disease, higher body mass index, higher fasting plasma glucose, and higher lipid levels, especially for patients <55 years of age. More women tended to receive medical therapy than men (51.6% vs. 42.8%, P < 0.01). The overall incidence of in-hospital major adverse cardiovascular events was higher in men than in women (4.1% vs. 2.6%, P < 0.05), whereas there was no sex difference in the in-hospital cardiac mortality (0.2% vs. 0.2%, P > 0.05).

CONCLUSIONS

Women had higher cholesterol levels, and were less likely to undergo revascularization therapy than similarly aged men, and elderly women had a higher prevalence of hypertension, diabetes, and chronic kidney disease than elderly men. In-hospital major adverse cardiovascular events were lower in women than in men; however, there was no sex difference in the in-hospital cardiac mortality.

摘要

背景

性别和年龄可能影响冠心病的发病机制,例如心血管危险因素、治疗和预后,但这些信息并不为人熟知。

方法

这是一项单中心回顾性队列研究。纳入 2013 年 1 月至 2018 年 6 月期间不稳定型心绞痛患者,并分为 4 个年龄组(<55 岁、55-64 岁、65-74 岁和≥75 岁)。研究探索了不同性别和年龄的心血管危险因素谱、治疗和住院预后差异。

结果

本研究共纳入 5908 例患者(2198 例女性)。女性患者比男性患者更年长(平均年龄 67 岁 vs. 62 岁)。大约 2/3 的患者有≥3 个心血管危险因素。男性更可能吸烟,而女性的总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇水平更高。≥65 岁的女性高血压、糖尿病和慢性肾脏病的发病率高于同年龄组的男性。年龄<65 岁的男性和女性家族性冠心病史更常见,体重指数更高,空腹血糖更高,血脂水平更高,尤其是年龄<55 岁的患者。与男性相比,更多的女性倾向于接受药物治疗(51.6% vs. 42.8%,P < 0.01)。男性住院期间主要不良心血管事件发生率高于女性(4.1% vs. 2.6%,P < 0.05),但住院期间心源性死亡率无性别差异(0.2% vs. 0.2%,P > 0.05)。

结论

女性的胆固醇水平较高,与同年龄组的男性相比,接受血运重建治疗的可能性较低,而老年女性的高血压、糖尿病和慢性肾脏病患病率高于老年男性。女性住院期间主要不良心血管事件发生率低于男性,但住院期间心源性死亡率无性别差异。

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