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外周动脉疾病患者临床特征和结局的性别差异:一项回顾性分析。

Sex-Based Differences in Clinical Characteristics and Outcomes among Patients with Peripheral Artery Disease: A Retrospective Analysis.

作者信息

De Matteis Giuseppe, Biscetti Federico, Della Polla Davide Antonio, Serra Amato, Burzo Maria Livia, Fuorlo Mariella, Nicolazzi Maria Anna, Novelli Angela, Santoliquido Angelo, Gambassi Giovanni, Gasbarrini Antonio, Flex Andrea, Franceschi Francesco, Covino Marcello

机构信息

Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.

Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.

出版信息

J Clin Med. 2023 Aug 3;12(15):5094. doi: 10.3390/jcm12155094.

Abstract

Peripheral arterial disease (PAD) is a prevalent medical condition associated with high mortality and morbidity rates. Despite the high clinical burden, sex-based differences among PAD patients are not well defined yet, in contrast to other atherosclerotic diseases. This study aimed to describe sex-based differences in clinical characteristics and outcomes among hospitalized patients affected by PAD. This was a retrospective study evaluating all patients with a diagnosis of PAD admitted to the Emergency Department from 1 December 2013 to 31 December 2021. The primary endpoint of the study was the difference between male and female PAD patients in cumulative occurrence of Major Adverse Cardiovascular Events (MACEs) and Major Adverse Limb Events. A total of 1640 patients were enrolled. Among them, 1103 (67.3%) were males while females were significantly older (median age of 75 years vs. 71 years; =< 0.001). Females underwent more angioplasty treatments for revascularization than men (29.8% vs. 25.6%; = 0.04); males were treated with more amputations (19.9% vs. 15.3%; = 0.012). A trend toward more MALEs and MACEs reported in the male group did not reach statistical significance (OR 1.27 [0.99-1.64]; = 0.059) (OR 0.75 [0.50-1.11]; = 0.153). However, despite lower extremity PAD severity seeming similar between the two sexes, among these patients males had a higher probability of undergoing lower limb amputations, of cardiovascular death and of myocardial infarction. Among hospitalized patients affected by PAD, even if there was not a sex-based significant difference in the incidence of MALEs and MACEs, adverse clinical outcomes were more common in males.

摘要

外周动脉疾病(PAD)是一种常见的医学病症,与高死亡率和发病率相关。尽管临床负担沉重,但与其他动脉粥样硬化疾病不同,PAD患者基于性别的差异尚未得到明确界定。本研究旨在描述住院的PAD患者在临床特征和预后方面的性别差异。这是一项回顾性研究,评估了2013年12月1日至2021年12月31日期间因PAD诊断入住急诊科的所有患者。该研究的主要终点是男性和女性PAD患者在主要不良心血管事件(MACE)和主要不良肢体事件的累积发生率上的差异。总共纳入了1640例患者。其中,1103例(67.3%)为男性,女性年龄显著更大(中位年龄75岁对71岁;P<0.001)。女性接受血管成形术进行血运重建的比例高于男性(29.8%对25.6%;P = 0.04);男性接受截肢治疗的比例更高(19.9%对15.3%;P = 0.012)。男性组报告的更多主要不良肢体事件和主要不良心血管事件的趋势未达到统计学意义(OR 1.27 [0.99 - 1.64];P = 0.059)(OR 0.75 [0.50 - 1.11];P = 0.153)。然而,尽管两性之间下肢PAD严重程度看似相似,但在这些患者中,男性进行下肢截肢、心血管死亡和心肌梗死的可能性更高。在受PAD影响的住院患者中,即使主要不良肢体事件和主要不良心血管事件的发生率在性别上没有显著差异,但不良临床结局在男性中更为常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab22/10420161/1dce37bd8e49/jcm-12-05094-g001.jpg

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