《国际循环》:众所周知,无论是男性还是女性,肥胖都是危险因素,但是肥胖男性与肥胖女性是否存在区别?相对于男性来说,女性肥胖是否带来了更大的风险?肥胖对于危险性的影响在男女间是否存在差异?
<International Circulation>: When it comes to the key clinical differences with myocardial ischemia in women versus men, what should clinicians be looking for?
《国际循环》:涉及到男性与女性心肌缺血的主要临床差异,临床医生应如何寻找?
Prof. Wenger:There is macro-vascular disease but there is also micro-vascular disease. In my cathlab, if we have a woman that comes to the cathlab with an abnormal ischemic evaluation by stress test and she doesn’t have epicardial disease in the cathlab, then we put a flow wire or pressure wire in and measure the coronary flow reserve. That will tell us if there is micro-vascular disease.
Wenger教授:有大血管疾病但同样也有微血管疾病,在我的导管室,如果女性病人在压力测试中有异常缺血评估,并且她不存在心外膜疾病。我们会放入流线或压力线并且测量冠状动脉血流储备。这将提示我们她是否有微血管疾病。
<International Circulation>:For these patients, when you are looking at PCI versus optimal medical therapy, are there different considerations for women than for men?
《国际循环》:对于这类病人,在考虑PCI与最佳药物治疗间,男性与女性间是否存在差异?
Prof. Wenger: Absolutely not. The only difference for women versus men is if you have an acute coronary syndrome, the women who do not have positive biomarkers or ECG and those that have unstable angina, because they have an increased incidence of complications of catheterization, an initial conservative strategy is recommended. Other than that, there is no difference.
Wenger教授:绝对没有,男性与女性患者间唯一的区别是在急性冠脉综合征时,心肌酶标志物和心电图阴性的女性患者和不稳定性心绞痛患者,因其心导管并发症的发生率会增加,因此建议初步实施保守治疗。除此之外,没有任何区别。