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Sex Disparities in Sudden Cardiac Death
Circulation: Arrhythmia and Electrophysiology ( IF 9.1 ) Pub Date : 2021-08-16 , DOI: 10.1161/circep.121.009834
Alexandra Butters 1, 2 , Clare Arnott 3, 4 , Joanna Sweeting , Bo Gregers Winkel 5 , Christopher Semsarian 2, 3, 6 , Jodie Ingles 1, 2, 3
Affiliation  

The overall incidence of sudden cardiac death is considerably lower among women than men, reflecting significant and often under-recognized sex differences. Women are older at time of sudden cardiac death, less likely to have a prior cardiac diagnosis, and less likely to have coronary artery disease identified on postmortem examination. They are more likely to experience their death at home, during sleep, and less likely witnessed. Women are also more likely to present in pulseless electrical activity or systole rather than ventricular fibrillation or ventricular tachycardia. Conversely, women are less likely to receive bystander cardiopulmonary resuscitation or receive cardiac intervention post-arrest. Underpinning sex disparities in sudden cardiac death is a paucity of women recruited to clinical trials, coupled with an overall lack of prespecified sex-disaggregated evidence. Thus, predominantly male-derived data form the basis of clinical guidelines. This review outlines the critical sex differences concerning epidemiology, cause, risk factors, prevention, and outcomes. We propose 4 broad areas of importance to consider: physiological, personal, community, and professional factors.

中文翻译:

心源性猝死的性别差异

女性心脏性猝死的总体发生率远低于男性,这反映了显着且通常未被充分认识的性别差异。女性在心脏性猝死时年龄较大,不太可能有先前的心脏诊断,并且不太可能在尸检中发现冠状动脉疾病。他们更有可能在家里、在睡觉时经历死亡,而且不太可能亲眼目睹。女性也更有可能出现无脉搏电活动或收缩,而不是心室颤动或室性心动过速。相反,女性在逮捕后接受旁观者心肺复苏或心脏干预的可能性较小。导致心源性猝死的性别差异的原因是招募到临床试验的女性很少,再加上总体上缺乏预先指定的按性别分列的证据。因此,主要来自男性的数据构成了临床指南的基础。本综述概述了有关流行病学、病因、危险因素、预防和结果的关键性别差异。我们建议考虑 4 个重要的重要领域:生理、个人、社区和专业因素。
更新日期:2021-08-17
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