Sex differences in investigations and outcomes among patients with type 2 myocardial infarction.
Sex differences in investigations and outcomes among patients with type 2 myocardial infarction.
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DOI：
10.1136/heartjnl-2021-319118
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Eggers KM
中科院分区：
文献类型：
--
作者：
Kimenai DM;Lindahl B;Chapman AR;Baron T;Gard A;Wereski R;Meex SJR;Jernberg T;Mills NL;Eggers KM
2型心肌梗死（MI）是一种异质性疾病，男女之间是否存在差异尚不清楚。我们评估了2型心肌梗死患者的临床特征、调查和结局的性别差异。在瑞典基于网络的心脏病循证护理增强和发展系统（SWEDEHEART）注册中，我们比较了诊断为1型或2型心肌梗死的冠状动脉护理病房收治的患者。性别分层Cox回归模型分别评估了男性和女性与全因死亡的关系。我们分别纳入了57 264例（中位年龄73岁，男性占65%）和6485例（中位年龄78岁，男性占50%）1型和2型心肌梗死患者。在接受超声心动图和冠状动脉造影的2型心肌梗死患者中，男性和女性的比例没有差异，但女性出现左心室（LV）损伤和阻塞性冠状动脉疾病（CAD）的可能性低于男性。与1型心肌梗死相比，2型心肌梗死患者不论性别均有更高的死亡风险(男性：调整后HR 1.55 (95% CI 1.44 ~ 1.67)；女性：调整后HR 1.34 （95% CI 1.24 - 1.45）。在2型心肌梗死患者中，女性的死亡风险低于男性(调整后HR 0.85 （95% CI 0.76 ~ 0.92)（男性，参考））。2型心肌梗死在男性和女性中发生率相同，我们没有发现在心脏检查患者选择中存在性别偏见的证据。2型心肌梗死患者的预后较差，但女性患阻塞性CAD或严重左室损害的可能性较低，并且比男性更有可能存活。
Type 2 myocardial infarction (MI) is a heterogenous condition and whether there are differences between women and men is unknown. We evaluated sex differences in clinical characteristics, investigations and outcomes in patients with type 2 MI. In the Swedish Web based system for Enhancement and Development of Evidence based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) registry, we compared patients admitted to coronary care units with a diagnosis of type 1 or type 2 MI. Sex-stratified Cox regression models evaluated the association with all-cause death in men and women separately. We included 57 264 (median age 73 years, 65% men) and 6485 (median age 78 years, 50% men) patients with type 1 and type 2 MI, respectively. No differences were observed in the proportion of men and women with type 2 MI who underwent echocardiography and coronary angiography, but women were less likely than men to have left ventricular (LV) impairment and obstructive coronary artery disease (CAD). Compared with type 1 MI, patients with type 2 MI had higher risk of death regardless of sex (men: adjusted HR 1.55 (95% CI 1.44 to 1.67); women: adjusted HR 1.34 (95% CI 1.24 to 1.45)). In those with type 2 MI, the risk of death was lower for women than men (adjusted HR 0.85 (95% CI 0.76 to 0.92) (men, reference)). Type 2 MI occurred in men and women equally and we found no evidence of sex bias in the selection of patients for cardiac investigations. Patients with type 2 MI had worse outcomes, but women were less likely to have obstructive CAD or severe LV impairment and were more likely to survive than men.
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影响因子：
5.9
作者：
Shah, Anoop S. V.;McAllister, David A.;Mills, Rosamund;Lee, Kuan Ken;Churchhouse, Antonia M. D.;Fleming, Kathryn M.;Layden, Elizabeth;Anand, Atul;Fersia, Omar;Joshi, Nikhil V.;Walker, Simon;Jaffe, Allan S.;Fox, Keith A. A.;Newby, David E.;Mills, Nicholas L.
通讯作者：
Mills, Nicholas L.
影响因子：
3.9
作者：
Gard A;Lindahl B;Hadziosmanovic N;Baron T
通讯作者：
Baron T
影响因子：
5.9
作者：
Saaby, Lotte;Poulsen, Tina Svenstrup;Mickley, Hans
通讯作者：
Mickley, Hans
DOI：
10.1136/heartjnl-2017-312409
发表时间：
2018-08
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Gard A;Lindahl B;Batra G;Hadziosmanovic N;Hjort M;Szummer KE;Baron T
通讯作者：
Baron T
影响因子：
5.7
作者：
Baron, Tomasz;Hambraeus, Kristina;Lindahl, Bertil
通讯作者：
Lindahl, Bertil