Association of Cardiovascular Disease With Respiratory Disease
Association of Cardiovascular Disease With Respiratory Disease
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DOI：
10.1016/j.jacc.2018.11.063
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发表时间：
2019-05-07
影响因子：
24
通讯作者：
Miller, Christopher A.
中科院分区：
文献类型：
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作者：
Carter, Paul;Lagan, Jakub;Miller, Christopher A.
背景呼吸系统疾病与个体心血管疾病之间的关系以及心血管疾病对呼吸系统疾病患者死亡率的影响尚不清楚。目的本研究旨在确定慢性阻塞性肺疾病(COPD)、哮喘和间质性肺疾病(ILD)与个体心血管疾病的关系，并评估个体心血管疾病对呼吸系统疾病全因死亡率的影响。方法作者对2000年1月1日至2013年3月31日在英格兰西北部7家国立卫生服务医院住院的所有有呼吸道诊断的患者进行了一项队列研究。结果共纳入COPD患者31,646例，哮喘患者60,424例，ILD患者1,662例。对照组分别为158,230,302,120和8,310名患者(总计随访2968,182人年)。COPD与缺血性心脏病(IHD)、心力衰竭(HF)、房颤和外周血管疾病独立相关，所有这些都与全因死亡率相关(例如，COPD与HF相关的优势比：2.18[95%可信区间：2.08至2.26]；COPD中HF对死亡率的贡献风险比：1.65[95%CI：1.61至1.68])。哮喘与IHD独立相关，多种心血管疾病导致死亡率(例如，心衰风险比：1.81[95%CI：1.75至1.87])。ILD与IHD和HF独立相关，两者都与死亡率相关。肺部疾病患者接受冠状动脉血运重建术的可能性较小。结论肺部疾病与心血管疾病独立相关，特别是IHD和HF，这两种疾病对全因死亡率有显著影响。然而，肺部疾病患者接受冠状动脉血运重建术的可能性较小。(C)2019年，由美国心脏病学会基金会主办。
BACKGROUND The relationship between respiratory diseases and individual cardiovascular diseases, and the impact of cardiovascular diseases on mortality in patients with respiratory disease, are unclear.OBJECTIVES This study sought to determine the relationship between chronic obstructive pulmonary disease (COPD), asthma and interstitial lung disease (ILD), and individual cardiovascular diseases, and evaluate the impact of individual cardiovascular diseases on all-cause mortality in respiratory conditions.METHODS The authors conducted a cohort study of all patients admitted to 7 National Health Service hospitals across the North West of England, between January 1, 2000, and March 31, 2013, with relevant respiratory diagnoses, with age-matched and sex-matched control groups.RESULTS A total of 31,646 COPD, 60,424 asthma, and 1,662 ILD patients were included. Control groups comprised 158,230, 302,120, and 8,310 patients, respectively (total follow-up 2,968,182 patient-years). COPD was independently associated with ischemic heart disease (IHD), heart failure (HF), atrial fibrillation, and peripheral vascular disease, all of which were associated with all-cause mortality (e.g., odds ratio for the association of COPD with HF: 2.18 [95% confidence interval (CI): 2.08 to 2.26]; hazard ratio for the contribution of HF to mortality in COPD: 1.65 [95% CI: 1.61 to 1.68]). Asthma was independently associated with IHD, and multiple cardiovascular diseases contributed to mortality (e.g., HF hazard ratio: 1.81 [95% CI: 1.75 to 1.87]). ILD was independently associated with IHD and HF, both of which were associated with mortality. Patients with lung disease were less likely to receive coronary revascularization.CONCLUSIONS Lung disease is independently associated with cardiovascular diseases, particularly IHD and HF, which contribute significantly to all-cause mortality. However, patients with lung disease are less likely to receive coronary revascularization. (C) 2019 by the American College of Cardiology Foundation.