Young women with PAD are at high risk of cardiovascular complications.
Young women with PAD are at high risk of cardiovascular complications.
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患有 PAD 的年轻女性发生心血管并发症的风险很高。
DOI：
10.1016/j.ejvs.2012.01.006
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
F. Moll
中科院分区：
文献类型：
--
作者：
P. Wisman;M. Tangelder;E. S. Hattum;G. J. D. Borst;F. Moll
外周动脉疾病（PAD）患者的预后研究很少，预后的决定因素主要在男性中进行研究。目前对妇女PAD的管理最多是基于混合人群的证据。因此，我们评估了313名男性和169名女性的风险和预后因素，荷兰旁路口服抗凝剂或阿司匹林的研究，其中长期随访data.METHODThe主要复合结局事件是血管性死亡，心肌梗死，中风，或大截肢在5年的后续行动。将单变量分析中p值<0.2的变量加入多变量考克斯比例风险模型。（71岁vs. 68岁; p < 0.01），PAD更晚期（严重肢体缺血（CLI）52.1 vs. 42.2%; p = 0.04），更常接受外周旁路手术作为主要干预（50.5 vs. 32.5%; p < 0.01），并且比男性更常患有高血压（48.5 vs. 33.2%; p < 0.01）。男性更常吸烟（63.6 vs. 53.3%; p = 0.03），既往心肌梗死更多（18.5 vs. 10.1%; p = 0.02）。共发生170起事件，女性74起（44%），男性96起（31%）。总体而言，主要结局事件的独立风险因素为年龄和严重肢体缺血。男性的独立危险因素为：（HR：1.06，95% CI：1.03-1.09），严重肢体缺血（HR：1.7，95% CI：1.05-2.7）和糖尿病（HR：1.7，95% CI：1.01-2.8）和女性严重肢体缺血（HR：3.5，95% CI：2.0-6.1），ABI≤0.9（HR：2.8，95% CI：1.2-6.1）和股-小腿分流术（HR：1.9，95% CI：1.1-3.3）。虽然性别不是一个独立的危险因素，在整体分析中，女性年龄小于60岁的心血管事件的风险增加相比，该年龄段的男性（HR：4.9，95%CI：1.8-13.6），而没有差异被视为60岁以上的年龄。据我们所知，这是第一项在60岁以下女性患者中显示如此糟糕结果的研究。更多的意识导致早期诊断和最佳治疗可能会改善（年轻）PAD女性的长期临床结局。
OBJECTIVESPrognostic research in patients with peripheral arterial disease (PAD) is scarce and determinants of outcome are mainly studied in males. The current management of PAD in women is based on evidence from, at best, mixed populations. We therefore assessed risk and prognostic factors in 313 men and 169 women from the Dutch Bypass Oral anticoagulants or Aspirin Study of whom long-term follow-up data were available.METHODThe primary composite outcome event was vascular death, myocardial infarction, stroke, or major amputation during 5 years of follow-up. Variables with a p-value <0.2 in the univariate analyses were added to the multivariate Cox proportional hazards model.RESULTSFemales were older (71 vs. 68 years; p < 0.01), had more advanced PAD (critical limb ischemia (CLI) 52.1 vs. 42.2%; p = 0.04), more often had peripheral bypass surgery as primary intervention (50.5 vs. 32.5%; p < 0.01), and had more often hypertension (48.5 vs. 33.2%; p < 0.01) than males. Males were more often smokers (63.6 vs. 53.3%; p = 0.03) and had more prior myocardial infarctions (18.5 vs. 10.1%; p = 0.02). In total 170 events occurred, 74 (44%) in females and 96 (31%) in males. Overall, independent risk factors for the primary outcome event were age and critical limb ischemia. Independent risk factors in males were: age (HR: 1.06, 95% CI: 1.03–1.09), critical limb ischemia (HR: 1.7, 95% CI: 1.05–2.7), and diabetes mellitus (HR: 1.7, 95% CI: 1.01–2.8) and in females critical limb ischemia (HR: 3.5, 95% CI: 2.0–6.1), ABI≤0.9 (HR: 2.8, 95% CI: 1.2–6.1), and femorocrural bypass (HR: 1.9, 95% CI: 1.1–3.3). Although sex was not an independent risk factor in the overall analysis, women younger than 60 years had an increased risk for cardiovascular events compared to men of that age (HR: 4.9, 95% CI: 1.8–13.6), whereas no difference was seen above 60 years of age.CONCLUSIONSRisk factors for cardiovascular events in patients with PAD differ between men and women. To our knowledge, this is the first study that shows such a bad outcome in female patients younger than 60 years of age. More awareness leading to early diagnosis and optimal treatment might improve long-term clinical outcome in (young) women with PAD.
老年女性下肢动脉疾病的患病率和相关性。
影响因子：
5
作者：
Vogt,MT;Cauley,JA;Kuller,LH;Hulley,SB
通讯作者：
Hulley,SB