Thachil Rosy, Nagraj Sanjana, Kharawala Amrin, Sokol Seth I
NYC Health + Hospitals/Jacobi Medical Center and the Albert Einstein College of Medicine, 1400 Pelham Parkway S, The Bronx, NY 14061, USA.
J Cardiovasc Dev Dis. 2022 Jul 25;9(8):234. doi: 10.3390/jcdd9080234.
Cardiovascular disease is the leading cause of death in women. Pulmonary embolism (PE) is the third most-common cause of cardiovascular death, after myocardial infarction (MI) and stroke. We aimed to evaluate the attributes and outcomes of PE specifically in women and explore sex-based differences. We conducted a systematic review of the literature using electronic databases PubMed and Embase up to 1 April 2022 to identify studies investigating PE in women. Of the studies found, 93 studies met the eligibility criteria and were included. The risk of PE in older women (especially >40 years of age) superseded that of age-matched men, although the overall age- and sex-adjusted incidence of PE was found to be lower in women. Risk factors for PE in women included age, rheumatologic disorders, hormone replacement therapy or oral contraceptive pills, pregnancy and postpartum period, recent surgery, immobilization, trauma, increased body mass index, obesity, and heart failure. Regarding pregnancy, a relatively higher incidence of PE has been observed in the immediate postpartum period compared to the antenatal period. Women with PE tended to be older, presented more often with dyspnea, and were found to have higher NT-proBNP levels compared to men. No sex-based differences in in-hospital mortality and 30-day all-cause mortality were found. However, PE-related mortality was higher in women, particularly in hemodynamically stable patients. These differences form the basis of future research and outlets for reducing the incidence, morbidity, and mortality of PE in women.
心血管疾病是女性死亡的主要原因。肺栓塞（PE）是心血管死亡的第三大常见原因，仅次于心肌梗死（MI）和中风。我们旨在评估女性肺栓塞的特征和结局，并探讨基于性别的差异。我们使用电子数据库PubMed和Embase对截至2022年4月1日的文献进行了系统综述，以识别调查女性肺栓塞的研究。在所发现的研究中，93项研究符合纳入标准并被纳入。老年女性（尤其是年龄>40岁）发生肺栓塞的风险超过年龄匹配的男性，尽管发现女性经年龄和性别调整后的肺栓塞总体发病率较低。女性肺栓塞的危险因素包括年龄、风湿性疾病、激素替代疗法或口服避孕药、妊娠和产后期、近期手术、制动、创伤、体重指数增加、肥胖和心力衰竭。关于妊娠，与产前相比，产后即刻肺栓塞的发病率相对较高。与男性相比，肺栓塞女性往往年龄较大，更常出现呼吸困难，且NT-proBNP水平较高。未发现住院死亡率和30天全因死亡率存在基于性别的差异。然而，女性肺栓塞相关死亡率较高，尤其是在血流动力学稳定的患者中。这些差异构成了未来研究以及降低女性肺栓塞发病率、发病率和死亡率的途径的基础。
