葡萄糖皮质醇在增加心血管风险中的作用
Hai-Wei Deng1,2, Wei-Yi Mei1,2, Qing Xu1,2
1Department of Cardiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
葡萄糖皮质类药物 (GCs) 增加了主要不良心血管事件 (MACE),冠心病 (CHD) 和心力衰竭 (HF) 的风险. 风险随着高累积或每日GCs剂量的增加而升级,突出显著的心血管问题.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 关于使用葡萄糖皮质体 (GC) 和心血管疾病 (CVD) 风险,存在相互矛盾的证据.
- 了解这种关联对于患者管理和风险分层至关重要.
研究的目的:
- 系统地审查和元分析GC使用与心血管风险之间的相关性.
- 评估GC对主要不良心血管事件 (MACE),冠心病 (CHD),心力衰竭 (HF),中风和全因死亡率的影响.
主要方法:
- 在PubMed和Embase进行了全面的文献搜索,截至2022年6月1日.
- 包括43项研究,涉及15572512名受试者.
- 对心血管结果的相对风险 (RR) 估计和95%置信区间 (CI) 的元分析.
主要成果:
- 糖使用与MACE (RR=1.27),CHD (RR=1.25) 和HF (RR=1.92) 的更高风险有关.
- 随着累积和每日GC剂量的增加,MACE风险增加.
- 在使用GC时,观察到每1000个人年中MACE病例的绝对增加为13.94例.
结论:
- GC的使用与MACE,CHD和HF的风险增加有关.
- 与GC相关的心血管风险似乎依赖于剂量.
- 在GC使用和增加全因死亡或中风之间没有发现显著的关联.
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