Significantly increased risk of chronic obstructive pulmonary disease amongst adults with predominantly mild congenital heart disease.
Significantly increased risk of chronic obstructive pulmonary disease amongst adults with predominantly mild congenital heart disease.
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DOI：
10.1038/s41598-022-21433-8
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发表时间：
2022-11-04
影响因子：
4.6
通讯作者：
Talavera, David
中科院分区：
文献类型：
--
作者：
Byrne, Dominic J. F.;Williams, Simon G.;Nakev, Apostol;Frain, Simon;Baross, Stephanie L.;Vestbo, Jorgen;Keavney, Bernard D.;Talavera, David
成人先天性心脏病（CHD）面临各种合并症的风险增加。先前对这一人群肺功能障碍的研究主要集中在具有严重冠心病表型的限制性肺疾病患者。我们在英国生物银行（UKB）中研究了轻度冠心病与慢性阻塞性肺疾病（COPD）的关系。电子健康记录（EHR）用于确定UKB的3385例冠心病病例和479,765例健康对照，然后进行了为期20年的病例对照分析，总共随访了1,950万人-年。我们的分析显示，患有冠心病的UKB参与者发生COPD的风险明显高于健康对照组（患病率8.7% vs 3.1%，未调整OR 2.98, 95% CI 2.63, 3.36, P = 1.40e−53）。在多变量调整的Cox回归框架中，观察到冠心病患者的吸烟率略有增加，但与COPD的关联在调整吸烟和其他已知调节COPD风险的因素后显示稳健（完全调整的HR 2.21, 95% CI 1.97, 2.48, P = 5.5e−41）。对成年冠心病患者的护理应以减轻其增加的COPD风险为目标，可能通过增加戒烟支持。
Adults with congenital heart disease (CHD) face increased risk of various comorbid diseases. Previous work on lung dysfunction in this population has mainly focused on restrictive lung disease, in patients with severe CHD phenotypes. We examined the association of mild CHD with chronic obstructive pulmonary disease (COPD) in the UK Biobank (UKB). Electronic health records (EHR) were used to identify 3385 CHD cases and 479,765 healthy controls in UKB, before performing a case–control analysis over a 20-year study period for a total of > 9.5 M person-years of follow-up. Our analysis showed that UKB participants with CHD are at substantially greater risk of developing COPD than healthy controls (8.7% vs 3.1% prevalence, unadjusted OR 2.98, 95% CI 2.63, 3.36, P = 1.40e−53). Slightly increased rates of smoking were observed amongst CHD cases, however the association with COPD was shown to be robust to adjustment for smoking and other factors known to modulate COPD risk within a multivariable-adjusted Cox regression framework (fully adjusted HR 2.21, 95% CI 1.97, 2.48, P = 5.5e−41). Care for adults with CHD should aim to mitigate their increased risk of COPD, possibly via increased smoking cessation support.
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影响因子：
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作者：
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