Takotsubo综合征并发心源性休克：性别差异
Cardiogenic Shock Complicating Takotsubo Syndrome: Sex-Related Differences.
作者信息
Tomasino Marco, Núñez-Gil Iván J, Martínez-Selles Manuel, Vedia Oscar, Corbí-Pascual Miguel, Salamanca Jorge, Blanco-Ponce Emilia, Cordón Clara Fernández, Almendro-Delia Manuel, Pérez-Castellanos Alberto, Martín-García Agustín, Vila-Sanjuán Sofía, Vazirani Ravi, Duran-Cambra Albert, Becerra-Muñoz Victor M, Guillén-Marzo Marta, Uribarri Aitor
机构信息
Department of Medicine Universitat Autònoma de Barcelona (UAB) Barcelona Spain.
Instituto Cardiovascular, Hospital Clínico San Carlos, Universidad Complutense Madrid Spain.
出版信息
J Am Heart Assoc. 2024 Dec 3;13(23):e036800. doi: 10.1161/JAHA.124.036800. Epub 2024 Nov 29.
BACKGROUND
Sex-related differences in Takotsubo syndrome have been described, but no information is available in patients who develop cardiogenic shock.
METHODS AND RESULTS
Of 412 patients with Takotsubo syndrome with cardiogenic shock, 71 (17.2%) were men. Male patients were older (71.1±12.2 versus 65.3±17.1 years, <0.001), more frequently smokers (47 [66.2%] versus 66 [19.4%], <0.01), with higher prevalence of neoplasms (6 [8.5%] versus 8 [2.3%], =0.01), lower left ventricular ejection fraction (31% versus 37%, <0.001), more frequent invasive mechanical ventilation (30 [42.3%] versus 90 [26.4%], =<0.01), higher rate of infections (43 [60.6%] versus 148 [43.4%], =<0.01), and longer in-hospital stay (19±20 days versus 13±15 days, =0.02). A total of 55 patients (13.3%) died during hospital admission, and 90 patients (21.8%) died at the end of the 5-year follow-up. Male sex was not significantly associated with the in-hospital (odds ratio, 1.31 [95% CI, 0.64-2.68]) or 5-year mortality rate (hazard ratio, 1.66 [95% CI, 0.93-2.94]). In the matched cohort, no significant differences in the short- and long-term mortality rate were found either.
CONCLUSIONS
Cardiogenic shock due to Takotsubo syndrome has high short- and long-term mortality rates that are similar in men and women.
背景
已有文献报道过应激性心肌病的性别差异，但对于发生心源性休克的患者，尚无相关信息。
方法与结果
在412例发生心源性休克的应激性心肌病患者中，男性71例（17.2%）。男性患者年龄更大（71.1±12.2岁 vs 65.3±17.1岁，<0.001），吸烟比例更高（47例[66.2%] vs 66例[19.4%]，<0.01），肿瘤患病率更高（6例[8.5%] vs 8例[2.3%]，=0.01），左心室射血分数更低（31% vs 37%，<0.001），有创机械通气更频繁（30例[42.3%] vs 90例[26.4%]，=<0.01），感染发生率更高（43例[60.6%] vs 148例[43.4%]，=<0.01），住院时间更长（19±20天 vs 13±15天，=0.02）。共有55例患者（13.3%）在住院期间死亡，90例患者（21.8%）在5年随访结束时死亡。男性与住院死亡率（优势比，1.31[95%CI，0.64 - 2.68]）或5年死亡率（风险比，1.66[95%CI，0.93 - 2.94]）无显著相关性。在匹配队列中，短期和长期死亡率也无显著差异。
结论
应激性心肌病所致的心源性休克有较高的短期和长期死亡率，且男女相似。
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