JACC Cardiovasc Interv:与男性相比,女性经导管主动脉瓣置换术的长期预后如何?

2017-10-31 fengxiangxin MedSci原创

本研究旨在验证女性与男性在经导管主动脉瓣置换(TAVR)术后的长期预后差异。

本研究旨在验证女性与男性在经导管主动脉瓣置换(TAVR)术后的长期预后差异。

TAVR通常在女性中进行,以前的研究在报道术后预后的性别差异时显示出相互矛盾的结果。此外,主要报道了短期预后。

为此,研究者检索了建库至2017年3月关于报道女性与男性TAVR预后的研究。研计算了随机效应DerSimonian-Laird风险比。结局包括短期(30天)和长期(> 1年)随访中的全因死亡率和主要心血管事件。

共分析了17项研究(8项TAVR注册研究; 47188例患者,49.4%为女性)。其中妇女年龄较大,但并存疾病较少。 30天时,相比男性,女性出血较多(p <0.001),血管并发症较多(p <0.001),中风/短暂性脑缺血发作较多(p = 0.02);全因死亡率(p = 0.19)或心血管死亡率(p= 0.91)无明显差异。

然而,在1年时,女性性别与全因死亡率较低(风险比:0.85; 95%置信区间:0.79至0.91; p <0.001),最长可随访时间较长(平均3.28±1.04年;风险比:0.86; 95%置信区间:0.81至0.92; p <0.001),较少的中度/重度主动脉瓣关闭不全(p = 0.001)和心血管死亡率较低(p = 0.009)相关。在多次次要分析中女性生存优势仍保持一致。

中风,中度/重度主动脉瓣关闭不全风险和全因死亡率似乎因瓣膜类型而有所不同。然而,没有显著的亚组相互作用。

结论:与男性相比,TAVR术后,尽管前期并发症风险更高,但女性有更好的长期生存。

原始出处:

Saad M, Nairooz R.et al.Long-Term Outcomes With Transcatheter Aortic Valve Replacement in Women Compared With Men: Evidence From a Meta-Analysis.JACC Cardiovasc Interv. 2017 Oct 11. pii: S1936-8798(17)31698-9. doi: 10.1016/j.jcin.2017.08.015.

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    2018-05-11 yxch48
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    2018-08-18 hbwxf
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encryptionId=79d99e04630, topicName=长期预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0e4823226485, createdName=ymljack, createdTime=Mon Jan 29 05:10:00 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938760, encodeId=17781938e6090, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Thu Nov 02 23:10:00 CST 2017, time=2017-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261137, encodeId=95e426113efd, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Tue Nov 14 01:45:31 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260976, encodeId=e9a32609e634, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Mon Nov 13 10:35:48 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260659, encodeId=bda42606595a, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sun Nov 12 03:02:34 CST 2017, time=2017-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260566, encodeId=f9e826056615, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:59:03 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260565, encodeId=43192605655d, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:58:10 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
  5. 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encryptionId=79d99e04630, topicName=长期预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0e4823226485, createdName=ymljack, createdTime=Mon Jan 29 05:10:00 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938760, encodeId=17781938e6090, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Thu Nov 02 23:10:00 CST 2017, time=2017-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261137, encodeId=95e426113efd, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Tue Nov 14 01:45:31 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260976, encodeId=e9a32609e634, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Mon Nov 13 10:35:48 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260659, encodeId=bda42606595a, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sun Nov 12 03:02:34 CST 2017, time=2017-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260566, encodeId=f9e826056615, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:59:03 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260565, encodeId=43192605655d, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:58:10 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-02 quxin068
  6. 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likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:58:10 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-14 1861ff6d37m

    好好学习天天上班

    0

  7. 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likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:58:10 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-13 1861ff6d37m

    好好学习天天上班

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Tue Nov 14 01:45:31 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260976, encodeId=e9a32609e634, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Mon Nov 13 10:35:48 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260659, encodeId=bda42606595a, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, 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likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:58:10 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-12 1861ff6d37m

    好好学习天天上班

    0

  9. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Tue Nov 14 01:45:31 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260976, encodeId=e9a32609e634, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Mon Nov 13 10:35:48 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260659, encodeId=bda42606595a, content=好好学习天天上班, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, 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likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/882034a42a23f5fa8650fc2dc453f603.jpg, createdBy=ce9e2143665, createdName=1861ff6d37m, createdTime=Sat Nov 11 18:58:10 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-11 1861ff6d37m

    好好学习天天上班

    0

  10. 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    2017-11-11 1861ff6d37m

    好好学习天天上班

    0

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