Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, ON, Canada (E.F.-U., L.S., M.O., L.B., E.H).
Cardiology Department, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Spain (E.F.-U.).
Circ Cardiovasc Interv. 2024 Nov;17(11):e014467. doi: 10.1161/CIRCINTERVENTIONS.124.014467. Epub 2024 Nov 19.
Evidence from trials suggests that patent foramen ovale closure is superior to medical therapy alone in reducing stroke recurrence in men but not in women. Evidence from real-world data on the impact of sex on outcomes after patent foramen ovale closure, however, remains scarce. Therefore, the present study aimed to assess sex-based differences in long-term outcomes after transcatheter closure of patent foramen ovale.
This was a single-center, retrospective cohort study enrolling patients who underwent transcatheter patent foramen ovale closure to prevent recurrent cerebrovascular events. Detailed information from medical charts was entered into a clinical registry, which has been linked to population-based administrative health databases in Ontario. Procedural, short, and long-term outcomes have been compared by sex.
Of the 783 patients included in the sample, 349 (44.5%) were women and 434 (55.5%) were men. Women were younger and had a higher rate of migraine, while men had a higher prevalence of cardiovascular risk factors. No differences were observed in procedural and 30-day outcomes by sex. At a median follow-up of 14 years, the event rates of recurrent cerebrovascular events, survival, and new-onset atrial fibrillation were not different by sex. In adjusted analysis, men experienced higher rates of pacemaker implantation (hazard ratio, 5.62 [95% CI, 1.57-20.1]).
No sex-based differences in recurrent cerebrovascular events, survival, or new-onset atrial fibrillation were observed in this study, suggesting equal benefits for both sexes. Future studies should report outcomes by sex to enhance the reproducibility of our findings and help support guideline development.
试验证据表明，卵圆孔未闭封堵术在降低男性中风复发率方面优于单纯药物治疗，但在女性中并非如此。然而，关于性别对卵圆孔未闭封堵术后结局影响的真实世界数据证据仍然很少。因此，本研究旨在评估经导管卵圆孔未闭封堵术后长期结局的性别差异。
这是一项单中心、回顾性队列研究，纳入了接受经导管卵圆孔未闭封堵术以预防复发性脑血管事件的患者。详细的病历信息被输入到一个临床登记处，该登记处已与安大略省的基于人群的行政健康数据库相链接。通过性别比较了手术、短期和长期结局。
在纳入的 783 名患者中，349 名（44.5%）为女性，434 名（55.5%）为男性。女性更年轻，偏头痛发生率更高，而男性心血管危险因素的患病率更高。性别之间在手术和 30 天结局方面无差异。在中位数为 14 年的随访中，复发性脑血管事件、生存和新发心房颤动的事件发生率在性别之间没有差异。在调整分析中，男性接受起搏器植入的比例更高（风险比，5.62[95%置信区间，1.57-20.1]）。
本研究未观察到性别对复发性脑血管事件、生存或新发心房颤动的影响存在差异，表明两性均可从中受益。未来的研究应按性别报告结局，以提高我们研究结果的可重复性，并有助于指导方针的制定。
