Huang Haozhang, Lai Wenguang, Li Qiang, Wei Haiyan, Remutula Nuerbahaer, Tuersun Tilakezi, Yang Zhou, Bao Kunming, Yan Zelin, Wang Bo, He Yibo, Chen Shiqun, Ou Chun-Quan, Yang Heyin, Chen Jiyan, Liu Jin, Liu Yong
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Cardiovasc Med. 2022 Apr 12;9:774365. doi: 10.3389/fcvm.2022.774365. eCollection 2022.
The sex difference trend of short-term mortality in coronary artery disease (CAD) is narrowing, which has been reported in the previous studies. However, no studies assess the sex difference temporal trends of CAD mortality in China especially long-term mortality trend.
Based on the registry at Guangdong Provincial People's Hospital which is the largest cardiovascular center in South China, this retrospective cohort study included 24,432 hospitalized patients with CAD confirmed by coronary angiography from January 2007 to December 2014. Women and men were followed for 1-year and 5-year all-cause mortality.
From 2007 to 2014, 5-year age-standardized mortality increased from 10.0 to 11.7% in men ( for trend < 0.001) and from 11.5 to 8.1% in women ( for trend = 0.99). The multivariable-adjusted hazard ratios (95% CI), which compare women with men, were from 1.02 (0.39-2.67) to 0.66 (0.39-1.12) for 1-year all-cause mortality and 1.23 (0.64-2.36) to 0.59 (0.44-0.79) for 5-year all-cause mortality ( for trend = 0.04).
Our study found that the mortality risk among men and women was similar in the 1-year prognosis of CAD, and there was no significant downward trend. In the 5-year long-term prognosis of CAD, the mortality risk among men continued to rise, while women had reached the peak, which means that the mortality risk continues to be higher among men than women.
既往研究报道，冠状动脉疾病（CAD）短期死亡率的性别差异趋势正在缩小。然而，尚无研究评估中国CAD死亡率的性别差异时间趋势，尤其是长期死亡率趋势。
本回顾性队列研究基于中国南方最大的心血管中心——广东省人民医院的登记资料，纳入了2007年1月至2014年12月期间24432例经冠状动脉造影确诊的CAD住院患者。对男性和女性进行1年和5年全因死亡率随访。
2007年至2014年，男性5年年龄标准化死亡率从10.0%升至11.7%（趋势<0.001），女性从11.5%降至8.1%（趋势=0.99）。1年全因死亡率的多变量调整风险比（95%CI），女性与男性相比，从1.02（0.39-2.67）降至0.66（0.39-1.12），5年全因死亡率从1.23（0.64-2.36）降至0.59（0.44-0.79）（趋势=0.04）。
我们的研究发现，CAD 1年预后中男性和女性的死亡风险相似，且无显著下降趋势。在CAD的5年长期预后中，男性的死亡风险持续上升，而女性已达峰值,这意味着男性的死亡风险继续高于女性。
