The role of estrogen, immune function and aging in heart transplant outcomes - 26/09/19
Abstract |
Background |
Aging and loss of estrogen suppress immune function, potentially improving survival after orthotopic heart transplant (OHT). The effect of female aging on OHT outcomes is unknown.
Methods |
Between 1995 and 2015, 41,299 adult OHT recipients (24.3% women) were studied using a retrospective multi-institutional cohort. Patients were stratified by age and gender into premenopausal (18–39 years), perimenopausal (40–49 years), and postmenopausal (≥50 years) groups. Kaplan-Meier survival analyses and risk-adjusted models examined gender differences across groups at one, five, and ten years.
Results |
Kaplan-Meier survival was equivalent for postmenopausal women and men, and lower for premenopausal women than men at all time points (p ≤ 0.05). Postmenopausal women had higher risk-adjusted five-year survival than premenopausal women (AOR 1.61, 95% CI 1.15–2.25, p = 0.006).
Conclusions |
Premenopausal women have lower unadjusted survival than men after OHT. Post-menopausal women have significantly better five-year survival than pre-menopausal women. Menopause may contribute to improved survival after OHT.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We compared survival between age-matched men and women after heart transplant. |
• | Post-menopausal women and age-matched men had equivalent unadjusted survival. |
• | Risk-adjusted survival was equivalent between men and women of all age groups. |
• | Postmenopausal women had better risk-adjusted survival than premenopausal women. |
• | Menopause, with associated loss of estrogen, may improve survival after transplant. |
Plan
Vol 218 - N° 4
P. 737-743 - octobre 2019 Retour au numéro
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