Lareyre Fabien, Raffort Juliette, Behrendt Christian-Alexander, Chaudhuri Arindam, Lê Cong Duy, Fabre Roxane, Pradier Christian, Bailly Laurent
Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, 06600 Antibes, France.
Université Côte d'Azur, Inserm U1065, C3M, 06204 Nice, France.
J Clin Med. 2022 Apr 18;11(8):2253. doi: 10.3390/jcm11082253.
The impact of sex on the outcomes of patients with cardiovascular disease is still incompletely understood. The aim of this nationwide multicenter observational study was to investigate the impact of sex on post-operative outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR) for intact thoracic aortic aneurysm (iTAA). The French National Health Insurance Information System was searched to identify these patients over a ten-year retrospective period. Post-operative outcomes, 30-day and overall mortality were recorded. Among the 7383 patients included (5521 men and 1862 women), females were significantly older than males (66.8 vs. 64.8 years, p < 0.001). They were less frequently diagnosed with cardiovascular comorbidities. Post-operatively, women had less frequently respiratory (10.9 vs. 13.7%, p = 0.002) as well as cardiac complications (34.3 vs. 37.3%, p = 0.023), but they had more frequently arterial complications (52.8 vs. 49.8%, p = 0.024). There was no significant difference on overall mortality for a mean follow-up of 2.2 years (26.9 vs. 27.6%, p = 0.58). In the multivariable regression model, female sex was not associated with 30-day or overall mortality. Although women had a favorable comorbidity profile, the short-term and long-term survival was similar. The significantly higher rate of arterial complications suggests that women may be at higher risk of access-vessel-related complications.
性别对心血管疾病患者预后的影响仍未完全明确。这项全国性多中心观察性研究的目的是调查性别对因完整胸主动脉瘤（iTAA）接受胸主动脉腔内修复术（TEVAR）患者术后预后的影响。通过检索法国国家健康保险信息系统，对十年回顾期内的这些患者进行识别。记录术后预后、30天及总体死亡率。在纳入的7383例患者中（5521例男性和1862例女性），女性患者明显比男性患者年龄大（66.8岁对64.8岁，p<0.001）。她们被诊断患有心血管合并症的频率较低。术后，女性发生呼吸系统并发症（10.9%对13.7%，p = 0.002）以及心脏并发症（34.3%对37.3%，p = 0.023）的频率较低，但发生动脉并发症的频率较高（52.8%对49.8%，p = 0.024）。平均随访2.2年时，总体死亡率无显著差异（26.9%对27.6%，p = 0.58）。在多变量回归模型中，女性性别与30天或总体死亡率无关。尽管女性的合并症情况较好，但其短期和长期生存率相似。动脉并发症发生率显著较高表明女性可能发生与入路血管相关并发症的风险更高。
