Incident cardiovascular disease in patients diagnosed with multiple sclerosis: A multi-database study
Incident cardiovascular disease in patients diagnosed with multiple sclerosis: A multi-database study
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DOI：
10.1016/j.msard.2019.101423
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发表时间：
2020-01-01
影响因子：
4
通讯作者：
Jick, Susan
中科院分区：
文献类型：
--
作者：
Persson, Rebecca;Lee, Sally;Jick, Susan
背景：关于多发性硬化症确诊后患者心血管疾病(CVD)发生率的最新数据很少。目的：描述确诊后多发性硬化症患者与匹配的非多发性硬化症患者的心血管疾病发生率。方法：我们在两个独立的电子医学数据库中进行了匹配的队列研究，分别是美国国防部军事医疗保健系统和英国的临床实践研究Datalink GOLD。研究人群包括所有首次被诊断为多发性硬化症、没有心血管病史或选定的与心血管疾病相关的可测量的共病的患者，以及匹配的没有心血管疾病和心血管相关并存的非多发性硬化症患者。结果：在两个数据库中，MS患者的静脉血栓栓塞率和外周血管病变的发生率是非MS患者的2倍，而女性MS患者的心肌梗死风险是非MS患者的2.5倍。其他心血管疾病的结果在数据库之间并不一致。结论：英国和美国的MS患者静脉血栓栓塞症和外周血管疾病的风险增加。女性MS患者发生心肌梗死的风险增加。
Background: Recent data on rates of cardiovascular disease (CVD) in patients after MS diagnosis are sparse.Objective: To describe incident CVD in MS patients after diagnosis compared with a matched non-MS population.Methods: We conducted a matched cohort study in two separate electronic medical databases, the United States Department of Defense military health care system and the United Kingdom's Clinical Practice Research Datalink GOLD. The study population included all patients with a first recorded diagnosis of MS and no history of CVD or selected measurable comorbidities associated with CVD and matched non-MS patients who were also free of CVD and the CVD associated comorbidities. We identified incident CVD outcomes first recorded after the MS diagnosis / matched date and calculated incidence rates and incidence rate ratios by type of CVD.Results: Rates of venous thromboembolism and peripheral vascular disease were 2-fold higher among MS than non-MS patients in both databases and the risk of myocardial infarction was 2.5 times higher among female MS patients compared with non-MS females in both databases. Other CVD outcomes were not consistent between databases.Conclusion: MS patients in the UK and the US have increased risk of venous thromboembolism and peripheral vascular disease. The risk of myocardial infarction is increased among female MS patients.