经导管主动脉瓣置换术后植入永久性起搏器的性别差异:一项系统综述和荟萃分析。

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-08-30 DOI:10.1080/14779072.2023.2250719
Frederick Berro Rivera, Sung Whoy Cha, John Paul Aparece, Jacques Simon T Gonzales, Wailea Faye C Salva, Nathan Ross B Bantayan, Genquen Phillip Carado, Vikram Sharma, Abdullah Al-Abcha, Michael Lawrenz Co, Fareed Moses S Collado, Annabelle Santos Volgman
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引用次数: 0

摘要

背景:关于性别对经导管主动脉瓣置换术(TAVR)后永久性起搏器植入(PPMI)的影响的证据有限。该荟萃分析的主要目的是确定性别在TAVR后需要PPMI的患者中的作用。方法:使用SCOPUS、MEDLINE和CINAHL数据库对2022年10月之前发表的研究进行文献检索。符合条件的研究包括已发表的随机对照试验(RCT)和观察性队列研究(OCS)文章,这些文章将PPMI报告为TAVR后起搏器状态的结果。本研究按照系统评价和荟萃分析首选报告项目(PRISMA)指南进行。使用漏斗图和艾格检验来估计发表偏倚。使用随机效应模型汇集数据。主要终点是TAVR后PPMI的性别差异,提取比值比和95%置信区间(CI)。结果:数据来自63项研究,共纳入79655名患者。累计PPMI发生率为15.5%(95%CI,13.6%-17.7%)。汇总分析显示,尽管接受TAVR的女性比男性多(51.6%,95%CI 50.4%-52.8%),但男性发生TAVR后PPMI的风险比女性高14.5%(OR 1.145,95%CI 1.047-1.253,P 结论:男性在TAVR后比女性更有可能经历PPMI。需要做进一步的研究来更好地解释这些观察到的结果差异。
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Sex differences in permanent pacemaker implantation after transcatheter aortic valve replacement: a systematic review and meta-analysis.

Background: There is limited evidence on the effect of sex on permanent pacemaker implantation (PPMI) after transcatheter aortic valve replacement (TAVR). The primary objective of this meta-analysis was to determine the role of sex among patients requiring PPMI post-TAVR.

Methods: A literature search was conducted using the SCOPUS, MEDLINE, and CINAHL databases for studies published until October 2022. Eligible studies included published randomized controlled trials (RCTs) and Observational Cohort Studies (OCS) articles that reported PPMI as an outcome of pacemaker status following TAVR. This study was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. Publication bias was estimated using a Funnel plot and Egger's test. Data were pooled using a random-effects model. The primary endpoint was the sex difference in PPMI after TAVR, with odds ratios and 95% confidence intervals (CIs) extracted.

Results: Data was obtained from 63 studies, and a total of 79,655 patients were included. The cumulative PPMI rate was 15.5% (95% CI, 13.6%-17.7%). The pooled analysis revealed that while there were more females than males undergoing TAVR (51.6%, 95% CI 50.4%-52.8%), males have a 14.5% higher risk for post-TAVR PPMI than females (OR 1.145, 95% CI 1.047-1.253, P < 0.01).

Conclusions: Males are more likely to experience PPMI after TAVR than females. Further research needs to be done to better explain these observed differences in outcomes.

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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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