I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine: Department of Functional and Laboratory Diagnostics.
I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine:Department of First Emergency Medical Aid and Emergency Medical Treatment.
Pol Merkur Lekarski. 2021 Jun 16;49(291):171-175.
Dyslipidemia has been widely acknowledged as one of the major predisposing factors for the development and progression of atherosclerosis. While advanced atherosclerosis confirmed to influence the prognosis of patients with acute coronary syndrome (ACS), it has not yet been established, whether this impact is gender-dependent.
The aim of study was to investigate possible gender-related effect of dyslipidemia and generalized atherosclerosis on the long-term outcomes in patients with ACS.
A total of 247 patients (88 women and 159 men) with ACS were included. Sample was divided into two groups, according to gender. Patients' lipid and comorbidity profiles were assessed. Cumulative major adverse coronary events (MACE) were estimated throughout 3-year follow-up period.
Women were older and had more comorbidities. Cumulative 3-year MACE rates were higher in women than in men (33% vs. 23%, p=0.06). In the multivariable Cox regression analysis abnormal lipid profiles were more significantly associated with higher MACE in females (HR=1.5, 95% CI [1-2,28], p<0.00001), compared with males (HR=1.0, 95% CI [0.5-2.08], p=0.4), as well as prior MI: (HR=3.8, 95% CI [1.4- 10.5], p<0.00001) vs. (HR=1.9, 95% [0.8-4.2], p=0.009) and concomitant peripheral artery disease (PAD): (HR=5.2, 95% CI [1.5-18.2], p<0.00001) vs. (HR=2.2, 95% CI [0.73-6.6], p=0.02) respectively.
In our study dyslipidemia, concomitant PAD and history of MI were independent predictors of higher MACE more significantly in females with ACS than in males. Thus, it can be assumed that female patients require an increased medical attention with strict serum lipid control.
本研究旨在探讨血脂异常和全身性动脉粥样硬化对 ACS 患者长期预后的可能性别相关影响。
共纳入 247 例 ACS 患者（88 名女性和 159 名男性）。根据性别将样本分为两组。评估患者的血脂和合并症情况。通过 3 年随访期间估计累积主要不良心血管事件（MACE）。
女性年龄较大且合并症更多。女性的 3 年累积 MACE 发生率高于男性（33% vs. 23%，p=0.06）。在多变量 Cox 回归分析中，异常血脂谱与女性更高的 MACE 更显著相关（HR=1.5，95%CI [1-2,28]，p<0.00001），而与男性（HR=1.0，95%CI [0.5-2.08]，p=0.4）相比，以及既往心肌梗死（HR=3.8，95%CI [1.4-10.5]，p<0.00001）相比（HR=1.9，95%[0.8-4.2]，p=0.009）和同时存在外周动脉疾病（PAD）（HR=5.2，95%CI [1.5-18.2]，p<0.00001）相比（HR=2.2，95%CI [0.73-6.6]，p=0.02）。
在我们的研究中，血脂异常、同时存在 PAD 和 MI 病史是 ACS 女性发生更高 MACE 的独立预测因素，比男性更显著。因此，可以假设女性患者需要更多的医疗关注，并严格控制血清脂质。
