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一项系统评价和荟萃分析,比较了男性和女性在冠状动脉旁路移植手术后短期结局方面的差异。

A systematic review and meta-analysis of differences between men and women in short-term outcomes following coronary artery bypass graft surgery.

机构信息

Cardiovascular Surgery Division, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.

Faculty of Medicine, University of Geneva, Geneva, Switzerland.

出版信息

Sci Rep. 2024 Sep 5;14(1):20682. doi: 10.1038/s41598-024-71414-2.

DOI:10.1038/s41598-024-71414-2
PMID:39237599
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11377420/
Abstract

We provide an update regarding the differences between men and women in short-term postoperative mortality after coronary artery bypass grafting (CABG) and highlight the differences in postoperative risk of stroke, myocardial infarction, and new onset atrial fibrillation. We included 23 studies, with a total of 3,971,267 patients (70.7% men, 29.3% women), and provided results for groups of unbalanced studies and propensity matched studies. For short-term mortality, the pooled odds ratio (OR) from unbalanced studies was 1.71 (with 95% CI 1.69-1.74, I = 0%, p = 0.7), and from propensity matched studies was 1.32 (95% CI 1.14-1.52, I = 76%, p < 0.01). For postoperative stroke, the pooled effects were OR = 1.50 (95% CI 1.35-1.66, I = 83%, p < 0.01) and OR = 1.31 (95% CI 1.02-1.67, I = 81%, p < 0.01). For myocardial infarction, the pooled effects were OR = 1.09 (95% CI = 0.78-1.53, I = 70%, p < 0.01) and OR = 1.03 (95% CI = 0.86-1.24, I = 43%, p = 0.18). For postoperative atrial fibrillation, the pooled effect from unbalanced studies was OR = 0.89 (95% CI = 0.82-0.96, I = 34%, p = 0.18). The short-term mortality risk after CABG is higher in women, compared to men. Women are at higher risk of postoperative stroke. There is no significant difference in the likelihood of postoperative myocardial infarction in women compared to men. Men are at higher risk of postoperative atrial fibrillation after CABG.

摘要

我们提供了关于冠状动脉旁路移植术(CABG)后短期术后死亡率的男性和女性之间差异的最新信息,并强调了术后中风、心肌梗死和新发心房颤动风险的差异。我们纳入了 23 项研究,共涉及 3971267 名患者(70.7%为男性,29.3%为女性),并提供了不平衡研究组和倾向匹配研究组的结果。对于短期死亡率,不平衡研究的汇总优势比(OR)为 1.71(95%CI 1.69-1.74,I=0%,p=0.7),倾向匹配研究的 OR 为 1.32(95%CI 1.14-1.52,I=76%,p<0.01)。对于术后中风,汇总效应为 OR=1.50(95%CI 1.35-1.66,I=83%,p<0.01)和 OR=1.31(95%CI 1.02-1.67,I=81%,p<0.01)。对于心肌梗死,汇总效应为 OR=1.09(95%CI=0.78-1.53,I=70%,p<0.01)和 OR=1.03(95%CI=0.86-1.24,I=43%,p=0.18)。对于术后心房颤动,不平衡研究的汇总效应为 OR=0.89(95%CI=0.82-0.96,I=34%,p=0.18)。与男性相比,CABG 后的短期死亡率风险在女性中更高。女性术后中风风险更高。与男性相比,女性术后心肌梗死的可能性没有显著差异。CABG 后男性心房颤动的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/821f39b196ca/41598_2024_71414_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/3c8723797dc1/41598_2024_71414_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/a2ba78666470/41598_2024_71414_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/ab7f9c66236c/41598_2024_71414_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/a926f1d95aa8/41598_2024_71414_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/821f39b196ca/41598_2024_71414_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/3c8723797dc1/41598_2024_71414_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/a2ba78666470/41598_2024_71414_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/ab7f9c66236c/41598_2024_71414_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/a926f1d95aa8/41598_2024_71414_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/11377420/821f39b196ca/41598_2024_71414_Fig5_HTML.jpg

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