绝经状态对女性冠心病患者植入药物支架后长期结局的影响

Effect of menopausal status on long-term outcome of women undergoing drug-eluting stent implantation

目的:探讨女性未绝经状态与冠心病植入药物支架后结局的关系。方法:回顾性分析2008年1月至2014年12月复旦大学附属中山医院数据库中小于55岁、植入药物支架的143例女性冠心病患者病例资料。根据介入手术时的绝经状态分为未绝经女性组(n=50)和已绝经女性组(n=93)。结果:与已绝经女性组相比,未绝经女性组年龄更小、冠心病家族史比例更高,但两组其他常见冠心病危险因素差异无统计学意义。两组患者起病方式和手术特点差异无统计学意义。中位随访时间823 d。两组主要心脏不良事件(major cardiac adverse events,MACEs)的发生率差异无统计学意义,无事件生存率差异无统计学意义。Cox回归分析显示,肾小球滤过率下降和多支血管病变是MACEs的预测因素(P<0.05),未绝经状态不是MACEs的预测因素。结论:在女性冠心病患者中,未绝经状态不是MACEs的影响因素。

Objective:To explore the relationship between menopausal status and long-term outcome of patients with coronary heart disease(CHD)after drug-eluting stent implantation.Methods:The data of 143 patients with CHD who were less than 55 years old and implanted with drug-eluting stents in Zhongshan Hospital,Fudan University from January 2008 to December 2014 were retrospectively analyzed.According to the status of menopause,patients were divided into premenopausal women group(n=50)and postmenopausal women group(n=93).Results:Compared with the postmenopausal women,the premenopausal women were younger,and had a higher rate of positive family history of CHD.The median follow-up time was 823 days.The incidence of major cardiac adverse events(MACEs)was not significantly different between the two groups.The event-free survival rate was not significantly different between the two groups.Cox regression analysis showed that the independent predictors of MACEs included the multi-vessel disease and lower estimated GFR other than menopausal status.Conclusions:In women with CHD,the premenopausal status might not be a influence factor for MACEs.