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心血管疾患の危険因子と静脈血栓塞栓症:メタ分析
Walter Ageno1, Cecilia Becattini, Timothy Brighton
1Department of Clinical Medicine, University of Insubria, Varese, Italy. agewal@yahoo.com
Circulation
|December 19, 2007
まとめ
肥満や高血圧などの心血管疾患のリスク要因は,静脈血栓塞栓症 (VTE) のリスクの増加と有意に関連しています. この発見は,VTE予防のためにこれらの要因を管理することの重要性を強調しています.
科学分野:
- 心血管医学 心血管医学
- 血液学 ヘマトロジ
- エピデミオロジー エピデミオロジー
背景:
- 静脈血栓塞栓症 (VTE) と動脈硬化症を別々の実体として捉える伝統的な見解は,共通の危険因子の証拠によって異議を唱えている.
- VTE患者では,対照群と比較して,無症状性動脈硬化症および心血管疾患の発生率が高くなります.
研究 の 目的:
- 主要な心血管リスク要因とVTEの発生との関連を評価するメタアナリシスを実施する.
- VTEスクリーニングと予防戦略におけるこれらの関連の臨床的関連性を評価する.
主な方法:
- MedlineとEMBASEのデータベースを体系的に検索した結果,21件の症例対照およびコホート研究 (63,552人の患者) が特定されました.
- 心血管疾患のリスク要因,研究の質,およびアウトカムに関するデータは,ランダム効果モデルを使用して抽出および分析されました.
- 統計的異質性は,チ2とI2の統計を用いて評価された.
主要な成果:
- 肥満 (OR 2.33),高血圧 (OR 1.51) および糖尿病 (OR 1.42) は,有意にVTEリスクの増加と関連していました.
- 喫煙 (OR 1.18) と高コレステロール血症 (OR 1.16) は関連性の傾向を示した.
- VTE患者は高密度リポプロテインコレステロールのレベルが有意に低下したが,総コレステロールと低密度リポプロテインコレステロールのレベルは違わなかった.
結論:
- 心血管疾患のリスク要因は,静脈血栓栓塞栓症と明らかに関連しています.
- これらの関連は,個々のスクリーニング,危険因子修正,および初次および二次VTE予防の両方にとって臨床的に重要である.
- 心血管疾患の危険因子とVTEを結びつける根本的なメカニズムを解明するために,さらなる将来性研究が推奨されています.
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