Sex Differences in the Outcomes of Elderly Patients with Acute Coronary Syndrome
Sex Differences in the Outcomes of Elderly Patients with Acute Coronary Syndrome
复制标题
老年急性冠脉综合征患者预后的性别差异
DOI：
10.1155/2020/5091490
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发表时间：
2020-05
影响因子：
2.1
通讯作者：
Zhou Shenghua
中科院分区：
文献类型：
--
作者：
Tai Shi;Li Xuping;Yang Hui;Zhu Zhaowei;Tang Liang;Fu Liyao;Hu Xinqun;Fang Zhenfei;Guo Yonghong;Zhou Shenghua
背景性别对急性冠状动脉综合征（ACS）患者预后的影响已被提出，但其对老年ACS患者的影响知之甚少。方法分析2013年1月至2017年12月在我科住院的老年（≥75岁）ACS患者的性别对住院期间和1年预后的影响。结果共纳入711例患者，其中女性273例（38.4%），男性438例（61.6%）。他们的年龄从75岁到94岁不等，男女之间相似。女性有更多的合并症（高血压（79.5% vs. 72.8%，p=0.050）、糖尿病（35.2% vs. 26.5%，p=0.014）和高尿酸血症（39.9% vs. 32.4%，p=0.042）），非ST段抬高ACS（NSTE-ACS）的患病率高于男性（79.5% vs. 71.2%，p=0.014）。男性的当前吸烟率（56.5% vs. 5.4%，p < 0.001）、肌酐水平（124.4 ± 98.6 vs. 89.9 ± 54.1，p < 0.001）和血运重建率（39.7% vs. 30.0%，p=0.022）更高，肌钙蛋白TnT和NT-proBNP倾向于高于女性。住院死亡率相似（3.5% vs. 4.4%，p=0.693），但女性的1年死亡率低于男性（14.7% vs. 21.7%，p=0.020）。多变量分析显示，女性是所有患者（OR = 0.565，95% CI 0.351-0.908，p=0.018）和STEMI患者（OR = 0.416，95% CI 0.184-0.940，p=0.035）调整后1年死亡率的保护因素。结论老年ACS患者中女性1年病死率低于男性，其死亡率与合并症及ACS类型有关。
Background The impact of sex on the outcome of patients with acute coronary syndrome (ACS) has been suggested, but little is known about its impact on elderly patients with ACS. Methods This study analyzed the impact of sex on in-hospital and 1-year outcomes of elderly (≥75 years of age) patients with ACS hospitalized in our department between January 2013 and December 2017. Results A total of 711 patients were included: 273 (38.4%) women and 438 (61.6%) men. Their age ranged from 75 to 94 years, similar between women and men. Women had more comorbidities (hypertension (79.5% vs. 72.8%, p=0.050), diabetes mellitus (35.2% vs. 26.5%, p=0.014), and hyperuricemia (39.9% vs. 32.4%, p=0.042)) and had a higher prevalence of non-ST-segment elevation ACS (NSTE-ACS) (79.5% vs. 71.2%, p=0.014) than men. The prevalence of current smoking (56.5% vs. 5.4%, p < 0.001), creatinine levels (124.4 ± 98.6 vs. 89.9 ± 54.1, p < 0.001), and revascularization rate (39.7% vs. 30.0%, p=0.022) were higher, and troponin TnT and NT-proBNP tended to be higher in men than in women. The in-hospital mortality rate was similar (3.5% vs. 4.4%, p=0.693), but the 1-year mortality rate was lower in women than in men (14.7% vs. 21.7%, p=0.020). The multivariable analysis showed that female sex was a protective factor for 1-year mortality in all patients (OR = 0.565, 95% CI 0.351–0.908, p=0.018) and in patients with STEMI (OR = 0.416, 95% CI 0.184–0.940, p=0.035) after adjustment. Conclusions Among the elderly patients with ACS, the 1-year mortality rate was lower in women than in men, which could be associated with comorbidities and ACS type.
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影响因子：
37.8
作者：
Hao, Yongchen;Liu, Jing;Zhao, Dong
通讯作者：
Zhao, Dong
DOI：
10.1161/circinterventions.117.005735
发表时间：
2018-01-01
影响因子：
5.6
作者：
Gupta, Tanush;Kolte, Dhaval;Bhatt, Deepak L.
通讯作者：
Bhatt, Deepak L.
影响因子：
5.9
作者：
McManus, David D.;Gore, Joel;Yarzebski, Jorge;Spencer, Frederick;Lessard, Darleen;Goldberg, Robert J.
通讯作者：
Goldberg, Robert J.
影响因子：
39.3
作者：
Mandelzweig, Lori;Battler, Alex;Behar, Shlomo
通讯作者：
Behar, Shlomo
影响因子：
120.7
作者：
Berger, Jeffrey S.;Elliott, Laine;Gallup, Dianne;Roe, Matthew;Granger, Christopher B.;Armstrong, Paul W.;Simes, R. John;White, Harvey D.;Van de Werf, Frans;Topol, Eric J.;Hochman, Judith S.;Newby, L. Kristin;Harrington, Robert A.;Califf, Robert M.;Becker, Richard C.;Douglas, Pamela S.
通讯作者：
Douglas, Pamela S.