Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies
Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies
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DOI：
10.1136/bmj.h7013
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发表时间：
2016-01-19
影响因子：
105.7
通讯作者：
Odutayo, Ayodele A.
中科院分区：
文献类型：
--
作者：
Emdin, Connor A.;Wong, Christopher X.;Odutayo, Ayodele A.
确定房颤是否是女性心血管疾病和死亡的更强风险因素。队列研究的荟萃分析。数据来源1966年1月至2015年3月期间发表的研究，通过Medline和Embase的系统检索以及参考文献的回顾确定。选择研究的资格队列研究，至少50名受试者有心房颤动，50名无心房颤动房颤与全因死亡率、心血管死亡率、中风、心脏事件（心源性死亡和非致命性心肌梗死）和心力衰竭之间的性别特异性相关性。采用逆方差加权随机效应荟萃分析方法汇总性别特异性相对危险度及其比值。房颤与女性全因死亡率的高风险相关（女性与男性的相对风险比为1.12，95%置信区间为1.07至1.17），（1.99，1.46至2.71），心血管死亡率（1.93，1.44至2.60），心脏事件（1.55，1.15至2.08）和心力衰竭（1.16，1.07至1.27）。结果在敏感性analysis.CONCLUSION房颤是一个更强的危险因素，心血管疾病和死亡的女性相比，男性，但需要进一步的研究，以确定任何因果关系。
OBJECTIVETo determine whether atrial fibrillation is a stronger risk factor for cardiovascular disease and death in women compared with men.DESIGNMeta-analysis of cohort studies.DATA SOURCESStudies published between January 1966 and March 2015, identified through a systematic search of Medline and Embase and review of references.ELIGIBILITY FOR SELECTING STUDIESCohort studies with a minimum of 50 participants with and 50 without atrial fibrillation that reported sex specific associations between atrial fibrillation and all cause mortality, cardiovascular mortality, stroke, cardiac events (cardiac death and non-fatal myocardial infarction), and heart failure.DATA EXTRACTIONTwo independent reviewers extracted study characteristics and maximally adjusted sex specific relative risks. Inverse variance weighted random effects meta-analysis was used to pool sex specific relative risks and their ratio.RESULTS30 studies with 4 371 714 participants were identified. Atrial fibrillation was associated with a higher risk of all cause mortality in women (ratio of relative risks for women compared with men 1.12, 95% confidence interval 1.07 to 1.17) and a significantly stronger risk of stroke (1.99, 1.46 to 2.71), cardiovascular mortality (1.93, 1.44 to 2.60), cardiac events (1.55, 1.15 to 2.08), and heart failure (1.16, 1.07 to 1.27). Results were broadly consistent in sensitivity analyses.CONCLUSIONAtrial fibrillation is a stronger risk factor for cardiovascular disease and death in women compared with men, though further research would be needed to determine any causality.