Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism
Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism
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DOI：
10.1093/aje/kwi309
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发表时间：
2005-11-15
影响因子：
5
通讯作者：
Rosner, B
中科院分区：
文献类型：
--
作者：
Glynn, RJ;Rosner, B
竞争风险的正式比较方法可能会澄清动脉粥样硬化危险因素与静脉血栓栓塞（VTE）发生之间关系的不确定性。医生健康研究（1982-2003）对 18,662 名既往无心肌梗塞、中风、静脉血栓栓塞或癌症病史且基线时报告的危险因素信息可用的美国男性医生进行了中位 20.1 年的跟踪调查。作者使用竞争风险生存分析方法来比较与年龄、高血压、胆固醇升高、糖尿病、吸烟、饮酒、运动频率、体重指数和身高相关的相对危险率。在随访期间，1,348 名男性中首先出现冠心病 (CHD)，902 名男性中出现中风，358 名男性中出现 VTE。所有三种结果的发生率均随着年龄的增长而增加，但中风的增加率最强。高血压、胆固醇升高、糖尿病和吸烟与冠心病和中风发病率增加相关，且程度相当，但与静脉血栓栓塞无关。相反，与 CHD 或中风相比，较高的体重指数与 VTE 风险的相关性更强，较高的男性发生 VTE 的风险显着增加，但患 CHD 的风险较低。 CHD 和中风具有大致可比的危险因素特征，但与 VTE 的特征有很大不同。对竞争风险进行正式比较的方法可能会澄清动脉粥样硬化危险因素与静脉血栓栓塞 (VTE) 发展之间关系的不确定性。医生健康研究（1982-2003）对 18,662 名既往无心肌梗塞、中风、静脉血栓栓塞或癌症病史且基线时报告的危险因素信息可用的美国男性医生进行了中位 20.1 年的跟踪调查。作者使用竞争风险生存分析方法来比较与年龄、高血压、胆固醇升高、糖尿病、吸烟、饮酒、运动频率、体重指数和身高相关的相对危险率。在随访期间，1,348 名男性中首先出现冠心病 (CHD)，902 名男性中出现中风，358 名男性中出现 VTE。所有三种结果的发生率均随着年龄的增长而增加，但中风的增加率最强。高血压、胆固醇升高、糖尿病和吸烟与冠心病和中风发病率增加相关，且程度相当，但与静脉血栓栓塞无关。相反，与 CHD 或中风相比，较高的体重指数与 VTE 风险的相关性更强，较高的男性发生 VTE 的风险显着增加，但患 CHD 的风险较低。 CHD 和中风具有大致相似的危险因素特征，但与 VTE 的特征有很大不同。
Methods for formal comparison of competing risks may clarify uncertainties about the associations of atherosclerotic risk factors with the development of venous thromboembolism (VTE). For a median of 20.1 years, the Physicians' Health Study (1982-2003) followed 18,662 US male physicians with no prior myocardial infarction, stroke, VTE, or cancer and for whom reported risk factor information was available at baseline. The authors used methods of competing risk survival analysis to compare relative hazard rates associated with age, hypertension, elevated cholesterol, diabetes, cigarette smoking, alcohol consumption, exercise frequency, body mass index, and height. During follow-up, coronary heart disease (CHD) occurred first in 1,348 men, stroke in 902 men, and VTE in 358 men. Incidence of all three outcomes increased with age, but the rate of increase was strongest for stroke. Hypertension, elevated cholesterol, diabetes, and smoking were associated with increased rates of CHD and stroke, with comparable magnitudes, but had no association with VTE. Conversely, higher body mass index was more strongly associated with risk of VTE than of either CHD or stroke, and taller men had a significantly increased risk of VTE but a lower risk of CHD. CHD and stroke have broadly comparable risk factor profiles that differ widely from the profile for VTE.Methods for formal comparison of competing risks may clarify uncertainties about the associations of atherosclerotic risk factors with the development of venous thromboembolism (VTE). For a median of 20.1 years, the Physicians' Health Study (1982-2003) followed 18,662 US male physicians with no prior myocardial infarction, stroke, VTE, or cancer and for whom reported risk factor information was available at baseline. The authors used methods of competing risk survival analysis to compare relative hazard rates associated with age, hypertension, elevated cholesterol, diabetes, cigarette smoking, alcohol consumption, exercise frequency, body mass index, and height. During follow-up, coronary heart disease (CHD) occurred first in 1,348 men, stroke in 902 men, and VTE in 358 men. Incidence of all three outcomes increased with age, but the rate of increase was strongest for stroke. Hypertension, elevated cholesterol, diabetes, and smoking were associated with increased rates of CHD and stroke, with comparable magnitudes, but had no association with VTE. Conversely, higher body mass index was more strongly associated with risk of VTE than of either CHD or stroke, and taller men had a significantly increased risk of VTE but a lower risk of CHD. CHD and stroke have broadly comparable risk factor profiles that differ widely from the profile for VTE.