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Sex Differences in In-Hospital Outcomes of Transcatheter Mitral Valve Repair (from a National Database).

经导管二尖瓣修复术住院结局的性别差异 (来自国家数据库)。

  • 影响因子:2.86
  • DOI:10.1016/j.amjcard.2020.01.013
  • 作者列表:"Elbadawi A","Elzeneini M","Thakker R","Mahmoud K","Elgendy IY","Megaly M","Hamed M","Omer MA","Chowdhury M","Ogunbayo G","Kamal D","Rangassety U","Jneid H","Gilani S","Khalife W
  • 发表时间:2020-05-01
Abstract

:There is paucity of data on sex differences in outcomes of transcatheter mitral valve repair (TMVR). We queried the National Inpatient Sample database (2012-2016) to identify hospitalizations for TMVR. We conducted a propensity matching analysis to compare hospitalizations for TMVR in men versus women. Our analysis yielded 10,014 hospitalizations for TMVR. TMVR was increasingly performed in both sexes at similar rate. Compared with men, women undergoing TMVR had fewer major comorbidities. After matching, there was no difference in in-hospital mortality between men and women (3.0% vs 2.4%, p = 0.33). Also, there was no difference between men and women in cardiac arrest (2.1% vs 1.3%, p = 0.17), cardiogenic shock (3.9% vs 3.5%, p = 0.66), mechanical support devices (2.4% vs 2.9%, p = 0.45), acute kidney injury (17.8% vs 14.7%, p = 0.08), hemodialysis (1.7% vs 1.6%, p = 0.81), respiratory complications (1.7% vs 1.4%, p = 0.65), acute stroke (1.4% vs 1.3%, p = 0.82), discharges to nursing facilities (12.3% vs 15.2%, p = 0.09), tamponade (0.5% vs 0.4%, p = 0.69), acute myocardial infarction (2.1% vs 2.4%, p = 0.71), and mean length of stay (6.03 ± 8.153 vs 6.08 ± 8.858 days, p = 0.82). TMVR in men was associated with higher incidence of ventricular arrhythmias (7.2% vs 4.1%, p = 0.01) and lower incidence of pacemaker implantations (0.4% vs 1.7%, p = 0.01). In conclusion, this observational study showed that TMVR is increasingly performed in both sexes at similar rate. Despite that women had less comorbidities, there was no difference in in-hospital mortality and major complications for TMVR among women compared with men. Future studies comparing the differences between both sexes in long-term outcomes are encouraged.

摘要

: 关于经导管二尖瓣修复术 (TMVR) 结局的性别差异的数据很少。我们查询了国家住院患者样本数据库 (2012-2016),以确定TMVR的住院治疗。我们进行了一项倾向匹配分析,比较男性与女性TMVR住院治疗情况。我们的分析产生了10,014例TMVR住院治疗。TMVR在男女两性中的发生率相似。与男性相比,接受TMVR的女性主要合并症较少。匹配后,男女住院死亡率无差异 (3.0% vs 2.4%,p = 0.33)。此外,在心脏骤停 (2.1% vs 1.3%,p   = 0.17) 、心源性休克 (3.9% vs 3.5%,p   = 0.66) 、机械支持装置 (2.4% vs 2.9%,p   = 0.45) 、急性肾损伤 (17.8% vs 14.7%,P = 0.08) 、血液透析 (1.7% vs 1.6%,p = 0.81) 、呼吸系统并发症(1.7% vs 1.4%,p  =   0.65),急性脑卒中患者,差异有统计学意义 (1.4% vs 1.3%,p  =   0.82),放电护理设施,差异有统计学意义 (12.3% vs 15.2%,p  =   0.09),填塞组 (0.5% vs 0.4%,p  =   0.69),急性心肌梗死 (ami),差异有统计学意义 (2.1% vs 2.4%,P = 0.71) 和平均住院时间 (6.03 ± 8.153 vs 6.08 ± 8.858天,p  =   0.82).男性TMVR与较高的室性心律失常发生率 (7.2% vs 4.1%,p = 0.01) 和较低的起搏器植入发生率 (0.4% vs 1.7%,p = 0.01) 相关。总之,这项观察性研究表明,TMVR在两性中的发生率越来越接近。尽管女性的合并症较少,但与男性相比,女性TMVR的住院死亡率和主要并发症没有差异。未来的研究,比较两性之间的长期结果的差异,鼓励。

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心脏瓣膜病方向

人的心脏有四个瓣膜,分别为二尖瓣、三尖瓣、主动脉瓣和肺动脉瓣。心脏瓣膜病就是指二尖瓣、三尖瓣、主动脉瓣和肺动脉瓣的瓣膜因风湿热、黏液变性、退行性改变、先天性畸形、缺血性坏死、感染或创伤等出现了病变,影响血流的正常流动,从而造成心脏功能异常,最终导致心力衰竭的单瓣膜或多瓣膜病变。随着人口老龄化加重,老年性瓣膜病以及冠心病、心肌梗死后引起的瓣膜病变也越来越常见。

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