无保护左主干病变男性和女性经皮冠状动脉介入治疗的结果比较。
Comparison of outcomes for percutaneous coronary intervention in men and women with unprotected left main disease.
作者信息
Liu Sheng-Wen, Guan Chang-Dong, Hu Feng-Huan, Chen Jue, Dou Ke-Fei, Yang Wei-Xian, Wu Yong-Jian, Yang Yue-Jin, Xu Bo, Qiao Shu-Bin
机构信息
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Catheterization Laboratories, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
J Geriatr Cardiol. 2021 Mar 28;18(3):168-174. doi: 10.11909/j.issn.1671-5411.2021.03.004.
BACKGROUND
Percutaneous coronary intervention (PCI) in patients with unprotected left main coronary artery disease (ULMCAD) is increasing strategy in coronary artery patients. However, there is a lack of knowledge on the impact of sex on outcomes of patients undergoing ULMCAD PCI.
METHODS
From January 2004 to December 2015, there were 3,960 patients undergoing ULMCAD PCI at our institution, including 3,121 (78.8%) men and 839 (21.2%) women. The clinical outcome included the incidence of major adverse cardiac events (MACE) (the composite of all-cause death, myocardial infarction (MI), and revascularization), all-cause death, MI, revascularization at three years follow-up.
RESULTS
Compared with men, women had not significantly different MACE (14.7% . 14.6%, = 0.89, all-cause death (3.5% . 3.7%, = 0.76), MI (5.0% . 4.3%, = 0.38), revascularization (9.1% . 8.9%, = 0.86), respectively. After adjustment, rates of MACE (HR = 1.49; 95% CI: 1.24-1.81; < 0.0001) and all-cause death (HR = 1.65; 95% CI: 1.09-2.48; = 0.017) occurred more frequently in male patients, as well as revascularization (HR = 1.46; 95% CI: 1.16-1.85; = 0.001).
CONCLUSION
In this analysis, compared to men, women undergoing ULMCAD PCI have better outcomes of MACE, all-cause death, and revascularization.
背景
在无保护左主干冠状动脉疾病（ULMCAD）患者中，经皮冠状动脉介入治疗（PCI）在冠状动脉疾病患者中是一种日益增加的治疗策略。然而，关于性别对接受ULMCAD PCI患者结局的影响，目前尚缺乏了解。
方法
2004年1月至2015年12月，我院有3960例患者接受了ULMCAD PCI，其中男性3121例（78.8%），女性839例（21.2%）。临床结局包括主要不良心脏事件（MACE）（全因死亡、心肌梗死（MI）和血运重建的复合事件）、全因死亡、MI以及三年随访时的血运重建情况。
结果
与男性相比，女性的MACE（14.7%对14.6%，P = 0.89）、全因死亡（3.5%对3.7%，P = 0.76）、MI（5.0%对4.3%，P = 0.38）、血运重建（9.1%对8.9%，P = 0.86）无显著差异。调整后，男性患者发生MACE（HR = 1.49；95%CI：1.24 - 1.81；P < 0.0001）、全因死亡（HR = 1.65；95%CI：1.09 - 2.48；P = 0.017）以及血运重建（HR = 1.46；95%CI：1.16 - 1.85；P = 0.001）的频率更高。
结论
在本分析中，与男性相比，接受ULMCAD PCI的女性在MACE、全因死亡和血运重建方面有更好的结局。
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