Short- and medium-term outcome differences in women and men after primary percutaneous transluminal mechanical revascularization for acute myocardial infarction.
Short- and medium-term outcome differences in women and men after primary percutaneous transluminal mechanical revascularization for acute myocardial infarction.
复制标题
急性心肌梗死初次经皮腔内机械血运重建后女性和男性的短期和中期结果差异。
DOI：
10.1016/s0002-9149(99)00839-5
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
F. Kiernan
中科院分区：
文献类型：
--
作者：
R. Azar;David D. Waters;R. McKay;S. Giri;J. Hirst;Joseph F Mitchell;D. Fram;F. Kiernan
与男性相比，患有急性心肌梗死(AMI)的女性在接受常规药物治疗和溶栓治疗时死亡率更高。直接经皮腔内机械血管重建术的结果还没有得到充分的研究。本研究旨在比较接受直接经皮血管重建术的女性和男性急性心肌梗死患者的特点和短期和中期结果。共有182名连续患者(62名女性和120名男性)纳入研究。基线临床特征相似，只是女性年龄比男性大，更容易出现心源性休克，并且参考血管直径较小。支架和阿昔单抗使用相同，但阿昔单抗在女性患者完成12小时输液前停用的频率更高，因为出血率更高。急性手术成功率相似(92%和97%)，但女性的死亡率要高得多，无论是在30天的随访期(10%对0.9%；p<；0.05)还是在平均6.9±4.1个月的随访期(15%对4.4%；p<；0.05)。女性也经历了比男性更多的不良心血管事件(复发的不稳定心绞痛或急性心肌梗死，靶血管再血管化)。然而，在多变量分析中控制了基线临床差异后，性别不是生存的独立预测因素，而年龄、心源性休克和完成12小时阿昔单抗注射是独立的预测因素。
Women presenting with acute myocardial infarction (AMI) have a higher mortality with conventional medical and thrombolytic therapy when compared with men. The outcome after primary percutaneous transluminal mechanical revascularization has not yet been fully investigated. This study was performed to compare the characteristics and the short- and medium-term outcomes of women and men with AMI treated with primary percutaneous revascularization. A total of 182 consecutive patients (62 women and 120 men) were included. Baseline clinical characteristics were similar except that women were older than men, presented more often in cardiogenic shock, and had smaller reference vessel diameters. Stents and abciximab were used equally, but abciximab was stopped more often in women before completion of the 12-hour infusion because of higher bleeding rates. Acute procedural success rates were similar (92% and 97%) but mortality was much higher in women, both at 30-day follow-up (10% vs 0.9%; p <0.05) and during a mean follow-up of 6.9 ± 4.1 months (15% vs 4.4%; p <0.05). Women also experienced more unfavorable cardiovascular events (recurrent unstable angina or AMI, target vessel revascularization) than men. However, after control for baseline clinical differences in a multivariate analysis, gender was not an independent predictor of survival, whereas age, cardiogenic shock, and completion of a 12-hour abciximab infusion were.