Cardio Genomics Program at Centenary Institute (A.B., J.I.), The University of Sydney.
Faculty of Medicine and Health (A.B., C.S., J.I.), The University of Sydney.
Circ Arrhythm Electrophysiol. 2021 Aug;14(8):e009834. doi: 10.1161/CIRCEP.121.009834. Epub 2021 Aug 16.
The overall incidence of sudden cardiac death is considerably lower among women than men, reflecting significant and often under-recognized sex differences. Women are older at time of sudden cardiac death, less likely to have a prior cardiac diagnosis, and less likely to have coronary artery disease identified on postmortem examination. They are more likely to experience their death at home, during sleep, and less likely witnessed. Women are also more likely to present in pulseless electrical activity or systole rather than ventricular fibrillation or ventricular tachycardia. Conversely, women are less likely to receive bystander cardiopulmonary resuscitation or receive cardiac intervention post-arrest. Underpinning sex disparities in sudden cardiac death is a paucity of women recruited to clinical trials, coupled with an overall lack of prespecified sex-disaggregated evidence. Thus, predominantly male-derived data form the basis of clinical guidelines. This review outlines the critical sex differences concerning epidemiology, cause, risk factors, prevention, and outcomes. We propose 4 broad areas of importance to consider: physiological, personal, community, and professional factors.
女性发生心源性猝死的总体发生率明显低于男性，这反映出显著且常常被低估的性别差异。女性发生心源性猝死时的年龄更大，先前被诊断为心脏病的可能性更小，尸检时冠状动脉疾病的检出率也更低。她们更有可能在居家、睡眠时发生猝死，且目击者较少。女性更可能表现为无脉性电活动或停搏，而不是心室颤动或室性心动过速。相反，女性更不可能接受旁观者心肺复苏或在心脏骤停后接受心脏介入治疗。心源性猝死中存在的性别差异的根本原因是临床试验中女性参与者人数不足，以及整体缺乏按性别分类的具体证据。因此，主要来源于男性的数据构成了临床指南的基础。本综述概述了在流行病学、病因、危险因素、预防和结局方面的关键性别差异。我们提出了 4 个需要考虑的重要领域：生理、个人、社区和专业因素。
