Sex Differences in 1-Year Outcomes After Percutaneous Coronary Intervention in the Veterans Health Administration.
Sex Differences in 1-Year Outcomes After Percutaneous Coronary Intervention in the Veterans Health Administration.
复制标题
退伍军人健康管理局经皮冠状动脉介入治疗后一年结果的性别差异。
DOI：
10.1089/jwh.2016.6057
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Ho,PMichael
中科院分区：
文献类型：
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作者：
Farmer,MelissaM;Stanislawski,MaggieA;Plomondon,MaryE;Bean-Mayberry,Bevanne;Joseph,NatariaT;Thompson,LaurenE;Zuchowski,JessicaL;Daugherty,StacieL;Yano,ElizabethM;Ho,PMichael
背景：经皮冠状动脉介入治疗（PCI）治疗阻塞性冠状动脉疾病的进展减少了主要不良事件，包括死亡率。然而，关于妇女和男子是否经历类似结果的证据喜忧参半。目的是研究在退伍军人健康管理局（VA）心导管实验室接受PCI的患者的全国人群中1年主要不良心脏结局的性别差异：纳入了2007年10月1日至2013年9月30日期间在VA医院接受PCI的所有退伍军人（N= 64，757;女性= 1，040）。考克斯比例风险模型比较了1年后的结果[再住院心肌梗死（MI），全因死亡率，主要不良心血管事件（MACE）]的性别。结果：女性退伍军人接受PCI更可能是年轻，黑人，肥胖，并有慢性抑郁症和不太可能有共同的心血管危险因素，并有以前的心脏事件比退伍军人男性。女性与男性的1年再住院率分别为2.1%和2.5%（p值= 0.57）;死亡率分别为3.5%和4.9%（p值= 0.14），MACE分别为5.4%和6.9%（p值= 0.18）。有没有显着的性别差异，在任何结果中的考克斯比例风险models.Conclusions：尽管在PCI的临床危险因素的差异，女性和男性退伍军人在VA心导管实验室治疗经历了可比的1年再住院MI，死亡率和MACE PCI后。这些结果表明，与一般人群相比，患有更多合并症和心理健康问题的全国患者人群中男性和女性的PCI术后1年结局相似。
Background:Advancements in percutaneous coronary intervention (PCI) for treating obstructive coronary artery disease have reduced major adverse events, including mortality. Yet, evidence as to whether women and men experience similar outcomes is mixed. The objective was to examine sex differences in 1-year major adverse cardiac outcomes for the national population of patients undergoing PCI at Veterans Health Administration (VA) cardiac catheterization laboratories.Methods:All Veterans undergoing PCI at VA hospitals between October 1, 2007 and September 30, 2013 (N= 64,757; Women = 1,040) were included. Cox proportional hazards models compared 1-year postprocedural outcomes [rehospitalization for myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE)] by sex.Results:Women Veterans undergoing PCI were more likely to be younger, black, obese, and have chronic depression and less likely to have common cardiovascular risk factors and to have had prior cardiac events than Veteran men. One-year rates for women versus men were 2.1% and 2.5% for rehospitalization (p-value = 0.57); 3.5% and 4.9% for mortality (p-value = 0.14), and 5.4% and 6.9% for MACE (p-value = 0.18). There were no significant sex differences in any of the outcomes in Cox proportional hazards models.Conclusions:Despite differences in clinical risk factors at the time of PCI, women and men Veterans treated at VA cardiac catheterization laboratories experienced comparable 1-year rehospitalization for MI, mortality, and MACE post-PCI. These results demonstrated similar 1-year post-PCI outcomes for men and women in a national population of patients who have more comorbidities and mental health issues than the general population.