女性心脏急症的处理:急性心血管护理协会 (ACVC)、欧洲经皮心血管介入协会 (EAPCI)、心力衰竭协会 (HFA) 和欧洲心律协会 (EHRA) 的临床共识声明,以及 ESC 心血管药物治疗工作组。

European heart journal open Pub Date : 2024-02-26 eCollection Date: 2024-03-01 DOI:10.1093/ehjopen/oeae011
Antonia Sambola, Sigrun Halvorsen, David Adlam, Christian Hassager, Susanna Price, Giuseppe Rosano, Francois Schiele, Lene Holmvang, Marta de Riva, Amina Rakisheva, Patrick Sulzgruber, Eva Swahn
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引用次数: 0

摘要

急性冠状动脉综合征、急性心力衰竭和心脏骤停等女性心脏急症与不良后果和死亡的高风险相关。虽然在有关这些疾病的临床研究中,女性的比例历来明显偏低,但指南推荐的这些急症治疗方法对男女一般都是相同的。然而,与男性相比,女性接受循证治疗的可能性较低。此外,主要或仅影响女性的特殊疾病,如自发性冠状动脉夹层、冠状动脉非阻塞性心肌梗死、拓扑型心肌病和围产期心肌病,在诊断和治疗方面都需要特别关注。在这份临床共识声明中,我们总结了目前对女性这些急症的治疗管理知识。我们提出了关键声明和具体的质量指标,以实现对两性的平等和特殊护理。最后,我们讨论了证据方面的一些不足,并鼓励在设计和开展进一步研究时充分关注性别特异性分析。
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Management of cardiac emergencies in women: a clinical consensus statement of the Association for Acute CardioVascular Care (ACVC), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the Heart Failure Association (HFA), and the European Heart Rhythm Association (EHRA) of the ESC, and the ESC Working Group on Cardiovascular Pharmacotherapy.

Cardiac emergencies in women, such as acute coronary syndromes, acute heart failure, and cardiac arrest, are associated with a high risk of adverse outcomes and mortality. Although women historically have been significantly underrepresented in clinical studies of these diseases, the guideline-recommended treatment for these emergencies is generally the same for both sexes. Still, women are less likely to receive evidence-based treatment compared to men. Furthermore, specific diseases affecting predominantly or exclusively women, such as spontaneous coronary dissection, myocardial infarction with non-obstructive coronary arteries, takotsubo cardiomyopathy, and peripartum cardiomyopathy, require specialized attention in terms of both diagnosis and management. In this clinical consensus statement, we summarize current knowledge on therapeutic management of these emergencies in women. Key statements and specific quality indicators are suggested to achieve equal and specific care for both sexes. Finally, we discuss several gaps in evidence and encourage further studies designed and powered with adequate attention for sex-specific analysis.

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