Luo Songyuan, Zhu Yi, Xie Enmin, Ding Huanyu, Yang Fan, Chen Lyufan, Liu Jitao, Liu Yuan, Xue Ling, Fan Ruixin, Luo JianFang, Chen Jiyan
Department of Cardiovascular, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, 569066Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
Department of Cardiology, 477093Guangzhou Panyu Central Hospital, Guangzhou, People's Republic of China.
Angiology. 2021 Jul;72(6):556-564. doi: 10.1177/0003319720987956. Epub 2021 Jan 28.
We aimed to investigate whether sex differences influence the clinical outcomes of patients who undergo thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). We retrospectively analyzed a prospectively maintained single-center cohort of patients with TBAD who underwent TEVAR between January 2010 and June 2017. We evaluated the in-hospital and long-term mortality and composite end point. Of the 913 patients, 793 (86.8%) were male and 120 (13.1%) were female. Compared to male patients, the female patients were older, more likely to have diabetes mellitus, but less likely to smoke or have hypertension. The proximal landing zone in 0 and 1 was higher in male patients ( = .023), who were more likely to require an aortic arch bypass. Endoleak, delirium, and ICU stay after stent-graft implantation were also more frequent in men. Sex factor was not associated with in-hospital or long-term mortality or the composite end point in the multivariable regression analyses and Cox regression model. The mean estimated survival time was similar between males and females (2462.9 ± 141.2 vs 2804.1 ± 117.4 days, = .167) in the propensity score-matched cohort. Despite distinct characteristics between sex, there was no sex-related difference in long-term clinical outcomes after TEVAR for TBAD.
我们旨在研究性别差异是否会影响接受胸主动脉腔内修复术（TEVAR）治疗B型主动脉夹层（TBAD）患者的临床结局。我们回顾性分析了2010年1月至2017年6月期间接受TEVAR治疗的TBAD患者的前瞻性单中心队列。我们评估了住院期间和长期死亡率以及复合终点。在913例患者中，793例（86.8%）为男性，120例（13.1%）为女性。与男性患者相比，女性患者年龄更大，更易患糖尿病，但吸烟或患高血压的可能性较小。男性患者在0区和1区的近端锚定区更高（P = 0.023），更有可能需要进行主动脉弓旁路移植术。男性患者在支架移植物植入后的内漏、谵妄和入住重症监护病房的情况也更常见。在多变量回归分析和Cox回归模型中，性别因素与住院期间或长期死亡率或复合终点无关。在倾向评分匹配队列中，男性和女性的平均估计生存时间相似（2462.9±141.2天对2804.1±117.4天，P = 0.167）。尽管性别之间存在明显特征，但TBAD患者接受TEVAR治疗后的长期临床结局没有性别相关差异。
