Khawar Muneeb, Shah Syed Abdullah, Komel Aqsa, Anfaal Zainab, Ali Umad, Mubarik Moosa, Buhadur Ali Muhammad Khan, Muhammad Awon, Saifullah Muneeb, Hadeed Khawar Mirza Muhammad, Qadeer Abdul, Rahman Saad Ur, Haider Mobeen, Mehdi Abbas Muhammad
Department of Medicine, King Edward Medical University, Lahore 54000, Punjab, Pakistan.
Department of Medicine, Nishtar Medical University, Multan 66000, Punjab, Pakistan.
World J Cardiol. 2025 Aug 26;17(8):109738. doi: 10.4330/wjc.v17.i8.109738.
Sex disparities in clinical outcomes following thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection (TBAD) are not well understood.
To evaluates the impact of sex on primary and secondary outcomes by comparing male and female cohorts undergoing TEVAR.
A systematic search of PubMed, EMBASE, Cochrane Library, and ScienceDirect identified five studies involving 2572 patients (1153 males and 1419 females). The primary outcome was hospital mortality. Secondary outcomes included reintervention rates, acute kidney injury (AKI), ischemic stroke, limb ischemia, and spinal cord ischemia. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic.
The primary outcome showed no significant difference between males and females for hospital mortality (OR: 1.13, 95%CI: 0.81-1.59, = 0.47, = 0). Among secondary outcomes, males had a significantly higher risk of AKI (OR: 1.55, 95%CI: 1.21-2.00, = 0.0006, ² = 0). No differences were observed for reintervention rates, ischemic stroke, limb ischemia, or spinal cord ischemia.
Male patients undergoing TEVAR for complicated TBAD are at increased risk of AKI but show comparable outcomes to females for mortality, ischemic events, reintervention, and other complications. Future research should explore mechanisms and strategies to optimize outcomes.
对于急性复杂性B型主动脉夹层（TBAD）行胸主动脉腔内修复术（TEVAR）后的临床结局性别差异尚不清楚。
通过比较接受TEVAR的男性和女性队列，评估性别对主要和次要结局的影响。
对PubMed、EMBASE、Cochrane图书馆和ScienceDirect进行系统检索，确定了五项涉及2572例患者（1153例男性和1419例女性）的研究。主要结局是住院死亡率。次要结局包括再次干预率、急性肾损伤（AKI）、缺血性卒中、肢体缺血和脊髓缺血。使用随机效应模型计算95%置信区间（CI）的比值比（OR）。使用I²统计量评估异质性。
主要结局显示男性和女性在住院死亡率方面无显著差异（OR：1.13，95%CI：0.81-1.59，I² = 0.47，P = 0）。在次要结局中，男性发生AKI的风险显著更高（OR：1.55，95%CI：1.21-2.00，I² = 0.0006，P = 0）。在再次干预率、缺血性卒中、肢体缺血或脊髓缺血方面未观察到差异。
因复杂性TBAD接受TEVAR的男性患者发生AKI的风险增加，但在死亡率、缺血性事件、再次干预和其他并发症方面与女性结局相当。未来的研究应探索优化结局的机制和策略。
