Contemporary sex differences in mortality among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis.
Contemporary sex differences in mortality among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis.
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DOI：
10.1136/bmjopen-2021-053379
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发表时间：
2022-03-09
期刊：
影响因子：
2.9
通讯作者：
Gao R
中科院分区：
文献类型：
--
作者：
Xi Z;Qiu H;Guo T;Wang Y;Li J;Li Y;Zheng J;Gao R
目的：探讨性别差异对ST段抬高型心肌梗死(STEMI)患者短期和长期死亡率的影响。对当代现有证据的系统回顾和荟萃分析。检索PubMed、Embase和Cochrane图书馆，检索2010年1月1日至2020年8月1日发表的报道STEMI患者性别结局的相关研究。风险比(RR)和95%的CI采用德西蒙尼模型和Laird随机效应模型计算。进行了敏感性分析，并检查了发表的偏倚。所有统计分析均使用STATA V.15.0进行。研究提供了STEMI患者按性别分层的短期或长期死亡率的数据。只有最近10年进行的研究才包括在内。主要结果是短期(住院或30天)和长期(至少12个月)的全因死亡。共纳入15项研究，涉及128 585名患者(女性31 706名(24.7%)，男性96 879名(75.3%))。在未调整的分析中，女性处于较高的短期死亡率(RR，1.73；95%CI1.53至1.96，p<；0.001，I2=77%)，但长期死亡率(RR，1.23；95%CI0.89至1.69，p=0.206，I2=77.5%)不高。当在Meta分析中使用来自个别研究的调整后的效果估计时，女性与较高的短期死亡率风险之间的关联仍然显著(RR，1.24；95%可信区间1.11至1.38，p<；0.001，I2=39.6%)。调整后的长期死亡率在女性和男性之间也是相似的(RR，1.11；95%CI 0.42to 1.80，p=0.670，I2=74.5%)。女性STEMI患者的短期死亡率增加，但长期死亡率没有增加。在调整了基线心血管危险因素和临床特征后，女性STEMI患者的短期死亡率仍然高于男性，这表明女性患者的管理需要进一步改善。
To assess the effect of sex differences on short-term and long-term mortality among patients with ST-segment elevation myocardial infarction (STEMI). Systematic review and meta-analysis of contemporary available evidence. PubMed, Embase and Cochrane Library were searched for relevant studies reporting sex-specific outcomes among patients with STEMI published between 1 January 2010 and 1 August 2020. Risk ratios (RRs) and 95% CIs were measured using DerSimonian and Laird random-effects model. Sensitivity analyses were performed and publication bias was also checked. All statistical analyses were performed using STATA V.15.0. Studies providing data about short-term or long-term mortality stratified by sex in patients with STEMI were included. Only study conducted in last 10 years were included. The primary outcome was all-cause death at short-term (in-hospital or 30 days) and long-term (at least 12 months) follow-up. A total of 15 studies involving 128 585 patients (31 706 (24.7%) female and 96 879 (75.3%) male) were included. In the unadjusted analyses, female were at a higher risk of short-term mortality (RR, 1.73; 95% CI 1.53 to 1.96, p<0.001, I2=77%) but not long-term mortality (RR, 1.23; 95% CI 0.89 to 1.69, p=0.206, I2=77.5%). When adjusted effect estimates from individual studies were used in meta-analysis, the association between female and higher risk of short-term mortality remained significant (RR, 1.24; 95% CI 1.11 to 1.38, p<0.001, I2=39.6%). And adjusted long-term mortality was also similar between female and male (RR, 1.11; 95% CI 0.42 to 1.80, p=0.670, I2=74.5%). An increased short-term but not long-term mortality was found in female with STEMI. After adjustment for baseline cardiovascular risk factors and clinical profiles, short-term mortality remains higher in female with STEMI compared with male, indicating the need for further improvements in management in female patients.
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影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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DOI：
10.1161/circoutcomes.119.005691
发表时间：
2019-10-01
影响因子：
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作者：
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通讯作者：
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作者：
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