Gender differences in outcome of conservatively treated patients with asymptomatic high grade carotid stenosis

被引:35
作者
Dick, P [1 ]
Sherif, C [1 ]
Sabeti, S [1 ]
Amighi, J [1 ]
Minar, E [1 ]
Schillinger, M [1 ]
机构
[1] Med Univ Vienna, Dept Angiol, A-1090 Vienna, Austria
关键词
atherosclerosis; carotid arteries; gender; outcome;
D O I
10.1161/01.STR.0000166056.04922.f2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Gender differences are currently becoming increasingly recognized as an important prognostic factor in patients with atherosclerotic disease. We investigated gender-related differences in vascular outcome and mortality of asymptomatic patients with high-grade internal carotid artery (ICA) stenosis. Methods-We enrolled 525 consecutive patients ( 325 males with a median age of 72 years and 200 females with a median age of 75 years) from a single center registry who were initially treated conservatively with respect to a neurologically asymptomatic >= 70% ICA stenosis. Patients were followed-up for a median of 38 months (interquartile range, 18 to 65) for major adverse cardiovascular, cerebral, and peripheral vascular events ( MACE: combined end point including myocardial infarction, stroke, [partial] limb amputation, and death), vascular mortality, and all-cause mortality. Results-Cumulative MACE-free survival rates in males and females at 1, 3, and 5 years were 83%, 65%, 48% versus 85%, 73%, and 67% (P=0.004), respectively. Adjusted hazard ratios for MACE, vascular mortality, and all-cause mortality for males were 1.96 (P=0.016), 2.48 (P<0.001), and 1.70 (P=0.007) as compared with females, irrespective of age, vascular risk factors, comorbidities, and the individual risk status estimated by the American Society of Anesthesiologists (ASA) score. Conclusion-Male patients with high-grade carotid artery stenosis are at a considerably higher risk for poor outcome than their female counterparts. In particular, the risk for fatal vascular events is substantially increased in males.
引用
收藏
页码:1178 / 1183
页数:6
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