系统性自身免疫性疾病患者的心血管事件风险:预后系统性审查和元分析
Claudia Asenjo-Lobos1, Leticia González2,3, Juan Francisco Bulnes4
1Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana Universidad de Desarrollo, Santiago, Chile.
概括
患有系统性自身免疫性疾病 (SAD) 的患者面临显著更高的心血管事件风险,包括死亡率,心脏病发作和中风. 这些发现强调了炎症在动脉样硬化中的关键作用,并指导了治疗策略.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 慢性炎症是动脉样硬化和心血管 (CV) 事件的已知危险因素.
- 系统性自身免疫性疾病 (SAD) 包括诸如系统性红斑狼 (SLE),类风湿性关节炎 (RA),牛皮 (Ps) 和化脊柱炎 (AS) 等疾病.
研究的目的:
- 与一般人群相比,评估SAD患者心血管事件的风险.
- 调查特定的SAD与心血管风险之间的关联.
主要方法:
- 在MEDLINE的系统文献搜索到2021年5月.
- 54项观察性研究的元分析,其中使用Hartung-Knapp-Sidik-Jonkman方法对24,107,072名参与者进行了观察.
- 评估心血管死亡率,心肌梗塞 (MI),中风和冠状动脉复血管化作为主要结局.
主要成果:
- 抑郁症与心血管死亡率 (HR 1.49),非致命性心脏病发作 (HR 1.42) 和非致命性中风 (HR 1.47) 的风险增加有关.
- RA,SLE和Ps (与关节炎) 显示出与更高的MI和中风风险有显著的关联.
- 抑郁症增加了主要不良心血管事件 (MACE) 的风险 (HR 1.45).
结论:
- 患有SAD的患者表现出高心血管发病率和死亡率风险.
- 系统性炎症在动脉样硬化驱动疾病的发展中起着至关重要的作用.
- 这些发现需要在SAD患者的治疗策略开发中加以考虑.
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