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RESEARCH PRODUCT

Sex-specific differences in chronic thromboembolic pulmonary hypertension. Results from the European CTEPH registry

David P. JenkinsIrene M. LangStavros KonstantinidesStavros KonstantinidesHiromi MatsubaraElie FadelFrederikus A. KlokFrederikus A. KlokJoanna Pepke-zabaNick H. KimEckhard MayerMichael M. MadaniPhilippe DartevelleGérald SimonneauBarco StefanoMarion Delcroix

subject

Malecardiovascular risk factorsAcute coronary syndromemedicine.medical_specialtyHypertension Pulmonary2720 Hematologypulmonary endarterectomyvenous thromboembolism610 MedizinChronic thromboembolic pulmonary hypertension610 Medicine & healthEndarterectomy030204 cardiovascular system & hematologyPulmonary Arterysurvivalchronic thromboembolic pulmonary hypertension03 medical and health sciencesPulmonary Disease Chronic Obstructive0302 clinical medicineInterquartile rangeInternal medicine610 Medical sciencesmedicineHumanssexRegistriesbusiness.industry10031 Clinic for AngiologyHazard ratioHematologyMiddle Agedmedicine.diseasePulmonary hypertensionObesityConfidence intervalmedicine.anatomical_structureChronic DiseasePopulation studyFemalebusinessPulmonary EmbolismArtery

description

BACKGROUND: Women are more susceptible than men to several forms of pulmonary hypertension, but have better survival. Sparse data are available on chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: We investigated sex-specific differences in the clinical presentation of CTEPH, performance of pulmonary endarterectomy (PEA), and survival. RESULTS: Women constituted one-half of the study population of the European CTEPH registry (N = 679) and were characterized by a lower prevalence of some cardiovascular risk factors, including prior acute coronary syndrome, smoking habit, and chronic obstructive pulmonary disease, but more prevalent obesity, cancer, and thyroid diseases. The median age was 62 (interquartile ratio, 50-73) years in women and 63 (interquartile ratio, 53-70) in men. Women underwent PEA less often than men (54% vs 65%), especially at low-volume centers (48% vs 61%), and were exposed to fewer additional cardiac procedures, notably coronary artery bypass graft surgery (0.5% vs 9.5%). The prevalence of specific reasons for not being operated, including patient's refusal and the proportion of proximal vs distal lesions, did not differ between sexes. A total of 57 (17.0%) deaths in women and 70 (20.7%) in men were recorded over long-term follow-up. Female sex was positively associated with long-term survival (adjusted hazard ratio, 0.66; 95% confidence interval, 0.46-0.94). Short-term mortality was identical in the two groups. CONCLUSIONS: Women with CTEPH underwent PEA less frequently than men, especially at low-volume centers. Furthermore, they had a lower prevalence of cardiovascular risk factors and were less often exposed to additional cardiac surgery procedures. Women had better long-term survival. ispartof: JOURNAL OF THROMBOSIS AND HAEMOSTASIS vol:18 issue:1 pages:151-161 ispartof: location:England status: published

yearjournalcountryeditionlanguage
2019-09-24
10.1111/jth.14629https://lirias.kuleuven.be/handle/123456789/641052