阻塞性肥厚型心肌病室间隔缩窄疗法的使用和疗效方面的性别差异

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
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引用次数: 0

摘要

背景研究阻塞性肥厚型心肌病患者在使用室间隔减容疗法(SRT)和并发症方面可能存在的性别差异的数据非常有限。我们的目的是根据性别评估 SRT 的使用情况和院内预后。我们利用 2017-2019 年全国住院患者样本数据库进行了一项回顾性队列研究。方法我们根据性别评估了SRT(外科室间隔肌切除术和酒精室间隔消融术)的使用情况。我们评估了接受 SRT 的患者的院内死亡率、起搏器植入率、植入式心律转复除颤器(ICD)植入率、缺血性中风率、大出血率和心包并发症率。结果共纳入了 72,680 例加权住院病例(中位年龄:67 岁 [范围:57-77];61% 为女性患者),只有 5.9% 的患者接受了 SRT 治疗。经过 IPTW 调整后,女性患者更有可能接受 SRT(调整风险比 [aRR] 1.18,95% 置信区间 [95% CI] 1.03-1.36)和酒精隔消融术(aRR 1.38,95% CI 1.04-1.83)。同样,与男性患者相比,女性患者接受起搏器植入术的频率更高(aRR 1.96,95% CI 1.10-3.50),接受 ICD 植入术的频率更低(aRR 0.58,95% CI 0.34-0.99)。结论我们的研究结果表明,女性患者接受 SRT 的几率略高,尤其是酒精室间隔消融术。男女患者的院内死亡率和术后并发症相似,但女性接受起搏器植入术的较多,接受 ICD 植入术的较少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Sex Disparities in the Use and Outcomes of Septal Reduction Therapies for Obstructive Hypertrophic Cardiomyopathy

Sex Disparities in the Use and Outcomes of Septal Reduction Therapies for Obstructive Hypertrophic Cardiomyopathy

Background

Data are limited that examine potential sex-based disparities in the utilization and complications of septal reduction therapy (SRT) in patients with obstructive hypertrophic cardiomyopathy. Our aim was to assess the use and in-hospital outcomes of SRT, according to sex. We performed a retrospective cohort study using the 2017-2019 National Inpatient Sample database. Adult patients with obstructive hypertrophic cardiomyopathy were identified.

Methods

We assessed the use of SRT (surgical septal myectomy and alcohol septal ablation), according to sex. In those who underwent SRT, rates of in-hospital mortality, pacemaker implantation, implantable cardioverter defibrillator (ICD) implantation, ischemic stroke, major bleeding, and pericardial complication were assessed. All outcomes were compared between groups using inverse probability of treatment weighting (IPTW), adjusting for demographics, comorbidity burden, and hospital characteristics.

Results

In total, 72,680 weighted hospitalizations (median age: 67 years [range: 57-77]; 61% female patients) were included, and only 5.9% of patients underwent SRT. After IPTW adjustment, female patients were more likely to undergo SRT (adjusted risk ratio [aRR] 1.18, 95% confidence interval [95% CI] 1.03-1.36) and alcohol septal ablation (aRR 1.38, 95% CI 1.04-1.83). Likewise, female patients received pacemaker implantation more often (aRR 1.96, 95% CI 1.10-3.50) and ICD implantation (aRR 0.58, 95% CI 0.34-0.99) less frequently, compared with male patients. No differences were present in rates of surgical septal myectomy, in-hospital mortality, ischemic stroke, major bleeding, and pericardial complication between groups.

Conclusions

Our results suggest that female patients were slightly more likely to undergo SRT, especially alcohol septal ablation. In-hospital mortality and postprocedural complications were similar between the sexes, but women received more pacemaker implantation and less ICD implantation.

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来源期刊
CJC Open
CJC Open Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
发文量
143
审稿时长
60 days
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