Sun Ji, Deng Qiang, Wang Jun, Duan Shoupeng, Chen Huaqiang, Zhou Huixin, Zhou Zhen, Yu Fu, Guo Fuding, Liu Chengzhe, Xu Saiting, Song Lingpeng, Wang Yijun, Feng Hui, Yu Lilei
Department of Cardiology, Renmin Hospital of Wuhan University, Cardiac Autonomic Nervous System Research Centre of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China.
Information Center, Renmin Hospital of Wuhan University, Wuhan, China.
Front Cardiovasc Med. 2022 Apr 4;9:853583. doi: 10.3389/fcvm.2022.853583. eCollection 2022.
Patients with lower extremity arteriosclerosis obliterans (LEASO) are more likely to appear to be associated with adverse cardiovascular outcomes. Currently, few studies have reported the sex-specific characteristics and risk of major cardiovascular and cerebrovascular adverse events (MACCEs) in LEASO. Our study was conducted to determine the characteristics and contributions of LEASO to MACCEs in males and females.
We conducted a single-center retrospective study of consecutively enrolled patients with first-diagnosed LEASO at Renmin Hospital of Wuhan University from November 2017 to November 2019. The ratio of patients between the LEASO and control groups was 1 to 1 and based on age, sex, comorbid diabetes mellitus and hypertension, current smoking and medications. The occurrence of MACCEs was used as the primary endpoint of this observational study.
A LEASO group ( = 430) and control group ( = 430) were enrolled in this study. A total of 183 patients experienced MACCEs during an average of 38.83 ± 14.28 months of follow-up. Multivariate Cox regression analysis indicated that LEASO was an independent predictor of the occurrence of MACCEs in all patients (HR: 2.448, 95% CI: 1.730-3.464, < 0.001). Subgroup analysis by sex subgroup was conducted for sex, and LEASO was also an independent predictor of the occurrence of MACCEs in both male cases (HR: 2.919, 95% CI: 1.776-4.797, < 0.001) and female cases (HR: 1.788, 95% CI: 1.110-2.880, = 0.017). Moreover, Kaplan-Meier analysis indicated no significant difference in event-free survival between patients of different sexes with LEASO (χ = 0.742, = 0.389).
LEASO tended to a useful risk stratified indicator for MACCEs in both male and female patients in our study. Notably, attention should be given to patients with LEASO who should undergo comprehensive cardiovascular evaluation and intervention, even if there is a lack of traditional cardiovascular risk factors.
下肢动脉硬化闭塞症（LEASO）患者更易出现不良心血管结局。目前，鲜有研究报道LEASO患者主要心血管和脑血管不良事件（MACCE）的性别特异性特征及风险。我们开展本研究以确定LEASO在男性和女性患者中对MACCE的特征及影响。
我们对2017年11月至2019年11月在武汉大学人民医院连续入组的初诊LEASO患者进行了单中心回顾性研究。LEASO组与对照组患者比例为1:1，且基于年龄、性别、合并糖尿病和高血压、当前吸烟情况及用药情况进行匹配。MACCE的发生作为本观察性研究的主要终点。
本研究纳入了一个LEASO组（n = 430）和一个对照组（n = 430）。在平均38.83±14.28个月的随访期间，共有183例患者发生MACCE。多因素Cox回归分析表明，LEASO是所有患者发生MACCE的独立预测因素（HR：2.448，95%CI：1.730 - 3.464，P < 0.001）。按性别亚组进行亚组分析，LEASO也是男性患者（HR：2.919，95%CI：1.776 - 4.797，P < 0.001）和女性患者（HR：1.788，95%CI：1.110 - 2.880，P = 0.017）发生MACCE的独立预测因素。此外，Kaplan - Meier分析表明，不同性别的LEASO患者无事件生存期无显著差异（χ² = 0.742，P = 0.389）。
在我们的研究中，LEASO倾向于成为男性和女性患者MACCE的一个有用的风险分层指标。值得注意的是，即使缺乏传统心血管危险因素，对于LEASO患者也应给予关注，他们应接受全面的心血管评估和干预。
