PDF(Pubmed)
Abstract：
Although women have lower age-standardized cardiovascular disease incidence, prevalence, and death-related rates than men, there are also reports indicating that women with cardiovascular disease receive less care, fewer investigations, and have poorer outcomes after a coronary event. The aims of this study were to compare the characteristics of men and women hospitalized for peripheral artery disease (PAD), their cardiovascular and limb outcomes, and their 1-year mortality. The study is a prospective registry collecting data about all consecutive patients hospitalized for PAD within the vascular department of the tertiary center Georges-Pompidou European Hospital (Paris, France). Patients were required to have one of three inclusion criteria: previous revascularization of the lower limb or any lower limb artery occlusion due to an atherosclerotic vascular disease or hemodynamic evidence of PAD. Exclusion criteria were patients with lower extremity arterial occlusion due to another cause. All patients were followed-up for at least 12 months after the initial hospitalization. Among the 235 patients included, there were 61 women (26%), older than men with a median age of 75.6 and 68.3 years, respectively. Main cardiovascular risk factors and comorbidities were similar for men and women except more former or current smokers [145 (83.4%) vs. 33 (54.1%)] and more history of coronary heart disease [42 (24.1%) vs. 7 (11.5%)] in men. Most patients [138 (58.8%)] had critical limb ischemia and 97 (41.3%) had claudication, with no difference for sex. After discharge, 218 patients received an antithrombotic therapy (93.2%), 195 a lipid-lowering drug (83.3%), 185 an angiotensin converting enzyme inhibitor or angiotensin-receptor blocker (78.9%), similarly between sex. At 1-year, overall mortality, major adverse cardiovascular events, major adverse limb events did not differ with 23 (13.2%), 11 (6.3%) and 32 (18.4%) in men, and 8 (13.1%), 3 (4.9%), 15 (24.6%) in women, respectively, despite the difference in age. Overall mortality, cardiovascular outcomes, limb revascularization or amputation did not differ between men and women, 1-year after hospitalization for PAD although the latter were older, less smoker and had less coronary artery disease. Due to the small size of this cohort, larger studies and future research are needed to better understand sex-specific mechanisms in the pathophysiology and natural history of PAD.
摘要：
尽管女性的年龄标准化心血管疾病发病率较低，患病率,死亡率高于男性，也有报告表明，患有心血管疾病的女性得到的护理较少，调查较少,并且在冠状动脉事件发生后预后较差。这项研究的目的是比较因外周动脉疾病（PAD）住院的男性和女性的特征，他们的心血管和肢体结果，和他们一年的死亡率。这项研究是一项前瞻性登记研究，收集了三级中心乔治-蓬皮杜欧洲医院（巴黎，法国)。患者需要有三个纳入标准之一：先前的下肢血运重建或由于动脉粥样硬化性血管疾病或PAD的血液动力学证据引起的任何下肢动脉闭塞。排除标准是由于其他原因导致下肢动脉闭塞的患者。所有患者在初次住院后随访至少12个月。在纳入的235名患者中，有61名女性(26%)，年龄大于男性，中位年龄为75.6岁和68.3岁，分别。男性和女性的主要心血管危险因素和合并症相似，除了更多以前或现在的吸烟者[145（83.4％）与33（54.1%）]和更多的冠心病病史[42（24.1%）与7（11.5%）]男性。大多数患者[138例（58.8%）]有严重肢体缺血，97例（41.3%）有跛行，对性别没有区别。放电后,218例患者接受抗血栓治疗（93.2%），195个降脂药物（83.3%），185血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂（78.9％），同样的性别之间。在1年，总死亡率，主要不良心血管事件，主要肢体不良事件与23例（13.2%）无差异，男性11人（6.3%）和32人（18.4%），和8（13.1％），3（4.9%），15（24.6%）女性，分别,尽管年龄不同。总死亡率,心血管结果，肢体血运重建或截肢在男性和女性之间没有差异，PAD住院后1年，尽管后者年龄较大，吸烟者较少，冠状动脉疾病较少。由于这个群体的规模很小，需要更大的研究和未来的研究来更好地了解PAD病理生理学和自然史中的性别特异性机制.
