Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: a retrospective matched cohort study
Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: a retrospective matched cohort study
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DOI：
10.1111/1471-0528.16692
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发表时间：
2021-04-06
影响因子：
5.8
通讯作者：
Adderley, N. J.
中科院分区：
文献类型：
--
作者：
Okoth, K.;Wang, J.;Adderley, N. J.
目的描述子宫内膜异位症的患病率和发病率，并估计子宫内膜异位症妇女心血管结局的风险。设计基于人群的队列研究，使用健康改善网络数据库。设置英国初级保健。人群年龄16 - 50岁的妇女从1995年至2018年进行随访。方法校正的风险比（aHR）采用多变量考克斯回归模型对子宫内膜异位症患者与非子宫内膜异位症患者的心血管结局进行比较。子宫内膜异位症的患病率和发病率分别使用年度（1998 - 2017）连续横断面和队列研究进行估计。主要结局指标主要结局是复合心血管疾病（CVD），包括缺血性心脏病（IHD）、心力衰竭（HF）和脑血管疾病。次要结果是心律失常，高血压和全因mortals.Results在所有，56 090名妇女子宫内膜异位症和223 669匹配对照无子宫内膜异位症纳入心血管风险的分析。与非子宫内膜异位症女性相比，子宫内膜异位症女性心血管结局的aHR为：复合CVD 1.24（95% CI 1.13 - 1.37）; IHD 1.40（95% CI 1.22 - 1.61）;脑血管疾病1.19（95% CI 1.04 - 1.36）; HF 0.76（95% CI 0.54 - 1.07）;心律失常1.26（95% CI 1.11 - 1.43）;高血压1.12（95% CI 1.07 - 1.17）和全因死亡率0.66（95% CI 0.59 - 0.74）。1998年子宫内膜异位症的发病率为12.3/10000人年，2017年为11.5/10000人年。子宫内膜异位症的患病率从1998年的119.7/万上升到2017年的201.3/万。结论子宫内膜异位症与心血管疾病的发生密切相关。年轻女性子宫内膜异位症是心血管风险评估和预防的潜在目标。Tweetable abstract子宫内膜异位症与心血管结局风险增加相关：英国回顾性配对队列研究
Objective To describe the prevalence and incidence of endometriosis and to estimate the risk of cardiovascular outcomes in women with endometriosis.Design Population-based cohort study using The Health Improvement Network database.Setting UK primary care.Population Women aged 16-50 years were followed from 1995 to 2018.Methods Adjusted hazard ratios (aHR) for cardiovascular outcomes comparing women with endometriosis with those without endometriosis were estimated using multivariable Cox regression models. Prevalence and incidence of endometriosis were estimated using annual (1998-2017) sequential cross-sectional and cohort studies, respectively.Main outcome measure The primary outcome was composite cardiovascular disease (CVD) including, ischaemic heart disease (IHD), heart failure (HF) and cerebrovascular disease. Secondary outcomes were arrhythmia, hypertension and all-cause mortality.Results In all, 56 090 women with endometriosis and 223 669 matched controls without endometriosis were included in the analysis of cardiovascular risk. Compared with women without endometriosis, the aHR for cardiovascular outcomes among women with endometriosis were: composite CVD 1.24 (95% CI 1.13-1.37); IHD 1.40 (95% CI 1.22-1.61); cerebrovascular disease 1.19 (95% CI 1.04-1.36); HF 0.76 (95% CI 0.54-1.07); arrhythmia 1.26 (95% CI 1.11-1.43); hypertension 1.12 (95% CI 1.07-1.17) and all-cause mortality 0.66 (95% CI 0.59-0.74). The incidence of endometriosis was 12.3 per 10 000 person-years in 1998 and 11.5 per 10 000 person-years in 2017. The prevalence of endometriosis increased from 119.7 per 10 000 population in 1998 to 201.3 per 10 000 population in 2017.Conclusion Endometriosis is associated with an increased risk of cardiovascular outcomes. Young women with endometriosis are a potential target for CVD risk assessment and prevention.Tweetable abstract Endometriosis is associated with increased risk of cardiovascular outcomes: a UK retrospective matched cohort study.