多发性硬化症诊断后心血管疾病风险增加。

High risk of cardiovascular diseases after diagnosis of multiple sclerosis.

机构信息

Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden.

出版信息

Mult Scler. 2013 Sep;19(10):1336-40. doi: 10.1177/1352458513475833. Epub 2013 Jan 30.

DOI:10.1177/1352458513475833

PMID:23364857

Abstract

BACKGROUND

Studies of the risk of cardiovascular diseases (CVDs) in patients with multiple sclerosis (MS) have the potential to improve our understanding of the etiology of and the heterogeneity of prognosis and outcomes.

OBJECTIVES

To investigate the risk of myocardial infarction (MI), stroke, heart failure (HF), and atrial fibrillation (AF) or Flutter in MS patients with different ethnicity, both female and male.

METHODS

Using Poisson regression, we performed a nationwide study in Sweden to investigate the association between the diagnosis of MS and the risk of MI, stroke, HF, or AF/Flutter in 8281 patients who were hospitalized due to MS from 1987 through 2009, plus 76,640 matched control individuals. We performed stratified analyses by sex, age at follow-up and country of birth.

RESULTS

Among MS patients, the incidence rate ratio for MI was 1.85 (95% confidence interval (CI) 1.59 to 2.15), for stroke was 1.71 (95% CI 1.46 to 2.00), for HF was 1.97 (95% CI 1.52 to 2.56) and for AF/Flutter was 0.63 (95% CI 0.46 to 0.87), as compared with individuals without MS. The increased risks were particularly prominent for women. These associations remained after stratification by sex, age and country of birth.

CONCLUSION

We recommend careful surveillance and preventive CVDs measures among MS patients, particularly among the women.

摘要

背景

对多发性硬化症 (MS) 患者发生心血管疾病 (CVD) 的风险进行研究，有可能增进我们对病因学和预后及结局异质性的理解。

目的

研究不同性别、不同种族的 MS 患者发生心肌梗死 (MI)、卒中和心力衰竭 (HF) 以及心房颤动 (AF) 或扑动的风险。

方法

我们在瑞典进行了一项全国性研究，采用泊松回归分析，对 1987 年至 2009 年期间因 MS 住院的 8281 例 MS 患者（MS 组）和 76640 例匹配对照者（对照组）进行了研究，调查 MS 诊断与 MI、卒中和 HF 或 AF/Flutter 发生风险之间的相关性。我们按性别、随访时的年龄和出生地进行了分层分析。

结果

在 MS 患者中，MI 的发病率比为 1.85（95%置信区间 [CI] 为 1.59 至 2.15），卒中的发病率比为 1.71（95%CI 为 1.46 至 2.00），HF 的发病率比为 1.97（95%CI 为 1.52 至 2.56），AF/Flutter 的发病率比为 0.63（95%CI 为 0.46 至 0.87），而对照组的发病率比则为 1。这些风险增加在女性中尤为明显。按性别、年龄和出生地分层后，这些相关性仍然存在。