Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary Fibrosis A Population-Based Study
Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary Fibrosis A Population-Based Study
复制标题
DOI：
10.1378/chest.14-0041
复制
发表时间：
2015-01-01
期刊：
影响因子：
9.6
通讯作者：
Navaratnam, Vidya
中科院分区：
文献类型：
--
作者：
Dalleywater, William;Powell, Helen A.;Navaratnam, Vidya
目的：患有特发性肺纤维化（IPF）的人已被证明患心血管（CV）疾病的风险增加，但原因尚不清楚。本研究的目的是比较IPF患者和普通人群中常见心血管危险因素的患病率，并确定诊断为IPF后缺血性心脏病（IHD）和卒中的发病率，控制这些危险因素。方法：我们使用来自英国大型初级保健数据库的数据，确定IPF事件病例和匹配的普通人群对照受试者。我们比较了IPF患者（诊断前）与普通人群中对照受试者的心血管疾病危险因素和心血管药物处方的患病率，并评估了IPF患者（诊断后）与对照受试者相比IHD和卒中的发病率。与对照受试者相比，IPF患者更有可能有高血压（OR，1.31; 95% CI，1.19-1.44）和糖尿病（OR，1.20; 95% CI，1.07-1.34）记录;他们也更有可能处方了多种CV药物。首次IHD事件发生率在患者中是对照组的两倍多（率比，2.32; 95%CI，1.85-2.93; P <0.001），但卒中的发生率仅略高（P = 0.09）。调整CV危险因素后，IHD和卒中的比率没有显著改变。结论：几种CV危险因素在IPF患者中更为普遍;然而，这并不能解释这组患者IHD率的增加。
OBJECTIVE: People with idiopathic pulmonary fibrosis (IPF) have been shown to be at an increased risk for cardiovascular (CV) disease, but reasons for this are unknown. The aim of this study was to compare the prevalence of common CV risk factors in people with IPF and the general population and establish the incidence of ischemic heart disease (IHD) and stroke aft er the diagnosis of IPF, controlling for these risk factors.METHODS: We used data from a large, UK primary care database to identify incident cases of IPF and matched general-population control subjects. We compared the prevalence of risk factors for CV disease and prescription of CV medications in people with IPF (before diagnosis) with control subjects from the general population and assessed the incidence of IHD and stroke in people with IPF (after diagnosis) compared with control subjects.RESULTS: We identified 3,211 cases of IPF and 12,307 control subjects. Patients with IPF were more likely to have a record of hypertension (OR, 1.31; 95% CI, 1.19-1.44), and diabetes (OR, 1.20; 95% CI, 1.07-1.34) compared with control subjects; they were also more likely to have been prescribed several CV drugs. The rate of first-time IHD events was more than twice as high in patients than control subjects (rate ratio, 2.32; 95% CI, 1.85-2.93; P < .001), but the incidence of stroke was only marginally higher (P = .09). Rate ratios for IHD and stroke were not altered substantially aft er adjusting for CV risk factors.CONCLUSIONS: Several CV risk factors were more prevalent in people with IPF; however, this did not account for the increased rate of IHD in this group of patients.