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女性心血管疾病的二级预防:缩小差距。

Secondary Prevention of Cardiovascular Disease in Women: Closing the Gap.

作者信息

Thakkar Aarti, Agarwala Anandita, Michos Erin D

机构信息

Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine Baltimore, MD, US.

Division of Cardiology, Baylor Scott and White Health Heart Hospital Baylor Plano Plano, TX, US.

出版信息

Eur Cardiol. 2021 Nov 8;16:e41. doi: 10.15420/ecr.2021.24. eCollection 2021 Feb.

Abstract

Cardiovascular disease (CVD) remains the leading cause of death in women globally. Younger women (<55 years of age) who experience MI are less likely to receive guideline-directed medical therapy (GDMT), have a greater likelihood of readmission and have higher rates of mortality than similarly aged men. Women have been under-represented in CVD clinical trials, which limits the generalisability of results into practice. Available evidence indicates that women derive a similar benefit as men from secondary prevention pharmacological therapies, such as statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, icosapent ethyl, antiplatelet therapy, sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists. Women are less likely to be enrolled in cardiac rehabilitation programs than men. Mitigating risk and improving outcomes is dependent on proper identification of CVD in women, using appropriate GDMT and continuing to promote lifestyle modifications. Future research directed at advancing our understanding of CVD in women will allow us to further develop and tailor CVD guidelines appropriate by sex and to close the gap between diagnoses, treatment and mortality.

摘要

心血管疾病(CVD)仍是全球女性的首要死因。发生心肌梗死(MI)的年轻女性(<55岁)比同龄男性更难接受指南指导的药物治疗(GDMT),再入院的可能性更大,死亡率更高。女性在心血管疾病临床试验中的代表性不足,这限制了研究结果在实际应用中的普遍性。现有证据表明,女性从二级预防药物治疗中获得的益处与男性相似,这些治疗包括他汀类药物、依折麦布、前蛋白转化酶枯草溶菌素/kexin 9型抑制剂、二十碳五烯酸乙酯、抗血小板治疗、钠-葡萄糖协同转运蛋白2抑制剂和胰高血糖素样肽-1受体激动剂。女性参加心脏康复项目的可能性低于男性。降低风险和改善预后取决于正确识别女性心血管疾病、采用适当的GDMT并持续促进生活方式的改变。未来旨在加深我们对女性心血管疾病理解的研究,将使我们能够进一步制定并根据性别调整合适的心血管疾病指南,缩小诊断、治疗和死亡率之间的差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e202/8591616/87cb3140c0bc/ecr-16-e41-g001.jpg

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