Muneeb Khawar, Syed Abdullah Shah, Aqsa Komel, Zainab Anfaal, Umad Ali, Moosa Mubarik, Muhammad Khan Buhadur Ali, Awon Muhammad, Muneeb Saifullah, Mirza Muhammad Hadeed Khawar, Abdul Qadeer, Saad Ur Rahman, Mobeen Haider, Abbas Muhammad Mehdi
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Secondary outcomes included reintervention rates, acute kidney injury (AKI), ischemic stroke, limb ischemia, and spinal cord ischemia. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>The primary outcome showed no significant difference between males and females for hospital mortality (OR: 1.13, 95%CI: 0.81-1.59, <i>P</i> = 0.47, <i>I</i> <sup>2</sup> = 0). Among secondary outcomes, males had a significantly higher risk of AKI (OR: 1.55, 95%CI: 1.21-2.00, <i>P</i> = 0.0006, <i>I</i>² = 0). No differences were observed for reintervention rates, ischemic stroke, limb ischemia, or spinal cord ischemia.</p><p><strong>Conclusion: </strong>Male patients undergoing TEVAR for complicated TBAD are at increased risk of AKI but show comparable outcomes to females for mortality, ischemic events, reintervention, and other complications. Future research should explore mechanisms and strategies to optimize outcomes.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 8","pages":"109738"},"PeriodicalIF":2.8000,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426978/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sex-based outcomes following thoracic endovascular aortic repair for acute complicated type B aortic dissection: A meta-analysis.\",\"authors\":\"Muneeb Khawar, Syed Abdullah Shah, Aqsa Komel, Zainab Anfaal, Umad Ali, Moosa Mubarik, Muhammad Khan Buhadur Ali, Awon Muhammad, Muneeb Saifullah, Mirza Muhammad Hadeed Khawar, Abdul Qadeer, Saad Ur Rahman, Mobeen Haider, Abbas Muhammad Mehdi\",\"doi\":\"10.4330/wjc.v17.i8.109738\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sex disparities in clinical outcomes following thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection (TBAD) are not well understood.</p><p><strong>Aim: </strong>To evaluates the impact of sex on primary and secondary outcomes by comparing male and female cohorts undergoing TEVAR.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, Cochrane Library, and ScienceDirect identified five studies involving 2572 patients (1153 males and 1419 females). The primary outcome was hospital mortality. Secondary outcomes included reintervention rates, acute kidney injury (AKI), ischemic stroke, limb ischemia, and spinal cord ischemia. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>The primary outcome showed no significant difference between males and females for hospital mortality (OR: 1.13, 95%CI: 0.81-1.59, <i>P</i> = 0.47, <i>I</i> <sup>2</sup> = 0). Among secondary outcomes, males had a significantly higher risk of AKI (OR: 1.55, 95%CI: 1.21-2.00, <i>P</i> = 0.0006, <i>I</i>² = 0). 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引用次数: 0
摘要
背景：急性合并B型主动脉夹层（TBAD）的胸血管内主动脉修复（TEVAR）术后临床结果的性别差异尚不清楚。目的：通过比较接受TEVAR的男性和女性队列，评估性别对主要和次要结局的影响。方法：系统检索PubMed、EMBASE、Cochrane Library和ScienceDirect，确定了5项研究，涉及2572例患者（男性1153例，女性1419例）。主要终点是住院死亡率。次要结局包括再干预率、急性肾损伤（AKI）、缺血性卒中、肢体缺血和脊髓缺血。使用随机效应模型计算95%置信区间（CI）的优势比（OR）。采用I²统计量评估异质性。结果：主要结局显示男女住院死亡率无显著差异（OR: 1.13, 95%CI: 0.81-1.59, P = 0.47, i2 = 0）。在次要结局中，男性发生AKI的风险明显更高（OR: 1.55, 95%CI: 1.21-2.00, P = 0.0006, I²= 0）。在再干预率、缺血性卒中、肢体缺血或脊髓缺血方面没有观察到差异。结论：接受TEVAR治疗并发TBAD的男性患者发生AKI的风险增加，但在死亡率、缺血事件、再干预和其他并发症方面，其结果与女性相当。未来的研究应探索优化结果的机制和策略。
Sex-based outcomes following thoracic endovascular aortic repair for acute complicated type B aortic dissection: A meta-analysis.
Background: Sex disparities in clinical outcomes following thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection (TBAD) are not well understood.
Aim: To evaluates the impact of sex on primary and secondary outcomes by comparing male and female cohorts undergoing TEVAR.
Methods: A systematic search of PubMed, EMBASE, Cochrane Library, and ScienceDirect identified five studies involving 2572 patients (1153 males and 1419 females). The primary outcome was hospital mortality. Secondary outcomes included reintervention rates, acute kidney injury (AKI), ischemic stroke, limb ischemia, and spinal cord ischemia. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic.
Results: The primary outcome showed no significant difference between males and females for hospital mortality (OR: 1.13, 95%CI: 0.81-1.59, P = 0.47, I2 = 0). Among secondary outcomes, males had a significantly higher risk of AKI (OR: 1.55, 95%CI: 1.21-2.00, P = 0.0006, I² = 0). No differences were observed for reintervention rates, ischemic stroke, limb ischemia, or spinal cord ischemia.
Conclusion: Male patients undergoing TEVAR for complicated TBAD are at increased risk of AKI but show comparable outcomes to females for mortality, ischemic events, reintervention, and other complications. Future research should explore mechanisms and strategies to optimize outcomes.
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