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Published on: December 31, 2017
Spinal cord injury and risk of overall and type specific cardiovascular diseases: A meta-analysis
ShengZhong Luo1,2,3, Tianlong Wu1,2,3, Xigao Cheng1,2,3
1Department of Orthopaedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Insights
Spinal cord injury (SCI) patients face a significantly higher risk of cardiovascular disease (CVD), including heart attack, atrial fibrillation, heart failure, and stroke. Increased awareness and proactive management are crucial for this population.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Cardiovascular disease (CVD) poses a growing health concern for individuals with spinal cord injury (SCI).
- Understanding the specific risks of CVD in SCI populations is essential for effective healthcare management.
Purpose of the Study:
- To conduct a meta-analysis exploring the association between SCI and the risk of overall CVD and specific cardiovascular events.
- To quantify the increased risk of various cardiovascular outcomes in individuals with SCI compared to controls.
Main Methods:
- A systematic meta-analysis was performed using data from PubMed, Embase, and the Cochrane Library, up to April 17, 2024.
- Included observational studies were assessed for risk of bias using the Newcastle-Ottawa and AHRQ scales.
- Data from 9 studies involving over 2.2 million individuals (including 193,045 with SCI) were aggregated using a random-effects model.
Main Results:
- SCI patients demonstrated a 1.56-fold increased risk of overall CVD.
- Elevated risks were observed for myocardial infarction (1.58-fold), atrial fibrillation (1.52-fold), heart failure (1.64-fold), and stroke (2.38-fold).
- Individuals with SCI and comorbidities had a 1.48-fold increased CVD risk, while those without comorbidities showed a 2.10-fold higher risk.
Conclusions:
- The overall risk of CVD is significantly higher in SCI patients compared to the general population.
- Specific cardiovascular events, including myocardial infarction, atrial fibrillation, heart failure, and stroke, are more prevalent in individuals with SCI.
- Healthcare providers should enhance vigilance regarding CVD risks in patients with spinal cord injury.
Background:
Cardiovascular disease (CVD) is a growing concern among people with spinal cord injury (SCI). This meta-analysis aims to explore the risk of overall CVD and specific types of cardiovascular events among SCI patients.
Methods:
This meta-analysis is registered on PROSPERO (CRD CRD42024537888). The data sources comprised PubMed, Embase, the Cochrane Library, and reference lists of the included studies. The literature collection span is from database establishment until April 17, 2024. This meta-analysis encompassed observational studies investigating the association between SCI and the risk of overall types of CVD or specific CVD types. Risk of bias was evaluated utilizing the Newcastle-Ottawa Quality Assessment Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) Scale. Odds ratios (ORs) with 95% confidence intervals (CIs) were aggregated using a random-effects model.
Results:
Our initial search generated 5357 relevant records form these international databases. This meta-analysis encompassed 9 observational studies involving 2,282,691 individuals, comprising 193,045 patients with SCI and 2,209,646 controls. We observed a 1.56-fold [OR = 1.56, 95% CI (1.43, 1.70), I2 = 91.3%, P < 0.001] rise in the risk of overall types of CVD among SCI patients, with a 1.82-fold increase in males and a 1.76-fold increase in females. SCI patients without comorbidities exhibited a 2.10-fold elevated risk of overall CVD types, while those with comorbidities had a 1.48-fold increased risk. Concerning specific CVD types, SCI patients showed a 1.58-fold [OR = 1.57, 95% CI (1.22, 2.03), I2 = 92.4%] higher risk of myocardial infarction, a 1.52-fold [OR = 1.52, 95% CI (1.07, 2.16), I2 = 88.7%] increase in atrial fibrillation, a 1.64-fold [OR = 1.64, 95% CI (1.22, 2.20), I2 = 95.5%] elevation in heart failure risk, and 2.38-fold [OR = 2.38, 95% CI (1.29, 4.40), I2 = 92.5%] increments in stroke risk. But there was no statistically significant difference in the risk of hypertension [OR = 1.54, 95% CI (0.98, 2.42), I2 = 96.6%].
Conclusions:
The risk of overall CVD in SCI patients surpassed that of the non-SCI control group, with elevated risks of specific cardiovascular events like myocardial infarction, atrial fibrillation, heart failure, and stroke. Clinicians should prioritize awareness of CVD risks in SCI patients.
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