口服双酸盐与心血管栓塞性缺血性中风的关联:一个嵌套的病例对照研究
Sara Rodríguez-Martín1, Diana Barreira-Hernández1, Ramón Mazzucchelli2
1Department of Biomedical Sciences (Pharmacology), University of Alcalá (IRYCIS), Alcalá de Henares, Spain.
Frontiers in pharmacology
|June 12, 2023
概括
口服双酸盐可能会增加心血管栓塞性缺血性中风 (IS) 的风险. 这种风险似乎取决于持续时间,并通过抗凝剂减轻,这表明与心血管栓塞事件的特定联系.
科学领域:
- 药物监督和药物流行病学
- 心血管疾病流行病学
- 骨质新陈代谢和治疗方法
背景情况:
- 双酸盐通常用于骨质疏松症和其他骨疾病.
- 以前的研究表明,双酸盐与心房动之间存在潜在联系,引发了人们对心血管栓塞风险的担忧.
- 关于双酸盐和缺血性中风 (IS) 的现有研究尚未区分心血管和非心血管亚型.
研究的目的:
- 调查口服双酸盐是否特别增加心血管缺血性中风 (IS) 的风险.
- 探索口服双酸盐治疗时间对IS风险的影响.
- 检查口服双酸盐,补充剂和抗凝剂之间关于IS风险的潜在相互作用.
主要方法:
- 使用西班牙BIFAP初级医疗保健数据库 (2002-2015) 进行了一项嵌套病例控制研究.
- 事件IS病例被确定并分类为心血管栓塞或非心血管栓塞.
- 根据年龄,性别和索引日期对每个病例的五个对照进行了匹配; 条件逻辑回归被用于评估关联.
主要成果:
- 口服双酸盐使用与IS的整体风险增加有关 (AOR=1.15).
- 这种风险在心血管栓塞性IS (AOR=1.35) 与非心血管栓塞性IS (AOR=1.03) 相比显著更高.
- 随着治疗持续时间的增加,心血管栓塞性胰岛症的风险增加 (p为趋势=0.001),并且因使用抗凝剂而减弱.
结论:
- 口服双酸盐与心血管栓塞性缺血性中风的风险增加特别相关.
- 这种关联取决于双酸盐治疗的持续时间.
- 抗凝剂的使用似乎可以减轻与双酸盐相关的心血管血性IS风险.
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