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患有炎症性肠道疾病的患者长期心律失常的风险:基于人口的,兄弟姐妹控制的队列研究
Jiangwei Sun1, Bjorn Roelstraete1, Emma Svennberg2
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
PLoS medicine
|October 19, 2023
概括
患有炎症性肠病 (IBD) 的患者面临更高的长期发病心律失常的风险,包括心房动和心室心律失常. 这种增加的风险在诊断后至少持续25年,突出显示需要提高临床意识.
科学领域:
- 胃肠病学和心脏病学
- 慢性疾病的流行病学.
- 炎症性肠病 (IBD) 研究研究
背景情况:
- 现有证据表明,炎症性肠病 (IBD) 和心血管疾病 (CVD) 之间存在联系.
- IBD与患心律失常的风险之间的具体关联仍然不清楚.
- 这项研究调查了被诊断为IBD的患者中心律不整的长期发生率.
研究的目的:
- 确定克罗恩病 (CD),性结肠炎 (UC) 和IBD未分类 (IBD-U) 的患者长期患心律失常的风险.
- 为了比较IBD患者的心律失常发病率与匹配的参考个体和IBD免费的兄弟姐妹.
- 为了评估心律失常风险在IBD诊断后的持续时间.
主要方法:
- 利用全国范围的瑞典组织病理学队列 (1969-2017) 识别了经活检确认的IBD (CD,UC,IBD-U) 和匹配的对照患者.
- 采用灵活的参数生存模型来估计整体和特定心律失常的调整危险比率 (aHR).
- 进行同胞对比分析以确认发现,并根据众多人口和临床共变量进行调整.
主要成果:
- 与参考人群相比,CD,UC和IBD-U患者的整体心律失常风险显著增加 (aHRs从1.14到1.30不等).
- 心律不整的高风险在诊断后的25年内持续存在,特定类型如心房动和心室心律不整更为常见.
- 兄弟姐妹分析证实了与IBD相关的心律失常风险增加,除了胸节律失常.
结论:
- 被诊断为IBD的患者长期患有各种心律失常的风险显著增加.
- 这种增加的风险在最初IBD诊断后至少持续25年.
- 医疗保健专业人员应保持对IBD患者心血管影响,特别是心律失常的高度认识.
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