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肺动脉高压

Abstract

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Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension Definition and Management of Segmental Pulmonary Hypertension Pulmonary hypertension related to congenital heart disease: a call for action 中国肺动脉高压诊断与治疗指南(2021版) Pulmonary Hypertension Caused by a Coconut Left Atrium Transthoracic echocardiography for the evaluation of children and adolescents with suspected or confirmed pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and D6PK ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)

Original ResearchVolume 75, Issue 14, April 2020

JOURNAL:JACC Article Link

Long-Term Outcomes in Women and Men Following Percutaneous Coronary Intervention

I Kosmidou, R Mehran, GW Stone et al. Keywords: mortality; outcomes; PCI; sex

ABSTRACT


BACKGROUND - Studies examining sex-related outcomes following percutaneous coronary intervention (PCI) have reported conflicting results.

 

OBJECTIVES - The purpose of this study was to examine the sex-related risk of 5-year cardiovascular outcomes after PCI.

 

METHODS - The authors pooled patient-level data from 21 randomized PCI trials and assessed the association between sex and major adverse cardiac events (MACE) (cardiac death, myocardial infarction [MI], or ischemia-driven target lesion revascularization [ID-TLR]) as well as its individual components at 5 years.

 

RESULTS - Among 32,877 patients, 9,141 (27.8%) were women. Women were older and had higher body mass index, more frequent hypertension and diabetes, and less frequent history of surgical or percutaneous revascularization compared with men. By angiographic core laboratory analysis, lesions in women had smaller reference vessel diameter and shorter lesion length. At 5 years, women had a higher unadjusted rate of MACE (18.9% vs. 17.7%; p = 0.003), all-cause death (10.4% vs. 8.7%; p = 0.0008), cardiac death (4.9% vs. 4.0%; p = 0.003) and ID-TLR (10.9% vs. 10.2%; p = 0.02) compared with men. By multivariable analysis, female sex was an independent predictor of MACE (hazard ratio [HR:]: 1.14; 95% confidence interval [CI:]: 1.01 to 1.30; p = 0.04) and ID-TLR (HR: 1.23; 95% CI: 1.05 to 1.44; p = 0.009) but not all-cause death (HR: 0.91; 95% CI: 0.75 to 1.09; p = 0.30) or cardiac death (HR: 0.97; 95% CI: 0.73 to 1.29; p = 0.85).

 

CONCLUSIONS - In the present large-scale, individual patient data pooled analysis of contemporary PCI trials, women had a higher risk of MACE and ID-TLR compared with men at 5 years following PCI.