Sex Difference in the Risk of Dementia in Patients with Atrial Fibrillation.
Sex Difference in the Risk of Dementia in Patients with Atrial Fibrillation.
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DOI：
10.3390/diagnostics11050760
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发表时间：
2021-04-23
期刊：
影响因子：
--
通讯作者：
Lin YS
中科院分区：
文献类型：
--
作者：
Chen YL;Chen J;Wang HT;Chang YT;Chong SZ;Hsueh S;Chung CM;Lin YS
心房颤动（AF）是痴呆的危险因素之一。在一般人群中，调整年龄后，女性是痴呆的一个不一致的危险因素，缺乏对其在AF患者中发展痴呆的影响的研究。本文旨在调查女性是否是AF患者痴呆的一个危险因素。2001-2013年期间新诊断的AF患者数据来自台湾国家健康保险研究数据库。排除标准为：人口统计学数据不完整、年龄< 20岁、风湿性心脏病、甲状腺功能亢进、既往心脏瓣膜手术和痴呆病史的患者。进行性别间倾向评分匹配（PSM），包括按年龄分层的合并症、药物和索引日期。主要结局是随访时痴呆的新诊断。共有117，517名男性和156，705名女性符合分析条件。在1：1 PSM后，100，065名男性和女性（年龄72.5 ± 12.5岁）被纳入分析。与男性相比，女性患痴呆症的风险随年龄而变化。≤55年的差异可忽略不计（亚分布HR（SHR）= 0.89，95% CI 0.73-1.07），但在56-65岁之间增加（SHR = 1.13，95% CI 1.02-1.25），66-75岁（SHR = 1.14，95%CI 1.09-1.20）、75-85岁（SHR = 1.11，95%CI 1.07-1.15）和>85岁（SHR 1.10，95%CI 1.04-1.16）。本研究确定，在年龄>56岁的AF患者中，与男性相比，女性会增加患痴呆症的风险。然而，女性对AF患者痴呆的影响在痴呆类型之间存在差异。
Atrial fibrillation (AF) is one of the risk factors for dementia. Female sex is an inconsistent risk factor for dementia after adjusting for age in the general population, and there lacks research on its impact in developing dementia in patients with AF. This paper aims to investigate whether female sex is a risk factor for dementia in AF patients. Data of patients with newly diagnosed AF between 2001–2013 were retrieved from Taiwan’s National Health Insurance Research Database. Exclusion criteria were: patients with incomplete demographic data, age < 20 years, rheumatic heart disease, hyperthyroidism, past valvular heart surgery, and a history of dementia. Propensity score matching (PSM) between sexes was performed, including comorbidities, medications and index date stratified by age. The primary outcome was a new diagnosis of dementia at follow-up. A total of 117,517 men and 156,705 women were eligible for analysis. After 1:1 PSM, both 100,065 men and women (aged 72.5 ± 12.5 years) were included for analysis. Dementia risk varied with age in women compared with men. The difference was negligible for ≤55 years (sub distribution HR (SHR) = 0.89, 95% CI 0.73–1.07), but increased between 56–65 years (SHR = 1.13, 95% CI 1.02–1.25), 66–75 years (SHR = 1.14, 95% CI 1.09–1.20), 75–85 years (SHR = 1.11, 95% CI 1.07–1.15) and >85 years (SHR 1.10, 95% CI 1.04–1.16) for females. This study establishes that female sex increases the risk of developing dementia compared to male sex in AF patients aged >56 years. However, the impact of female sex on dementia in AF patients differs between dementia types.
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