Navaratnam Vidya, Millett Elizabeth R C, Hurst John R, Thomas Sara L, Smeeth Liam, Hubbard Richard B, Brown Jeremy, Quint Jennifer K
Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Thorax. 2017 Feb;72(2):161-166. doi: 10.1136/thoraxjnl-2015-208188. Epub 2016 Aug 29.
There are limited data on the burden of cardiovascular comorbidities in people with bronchiectasis. Our cross-sectional study estimates the burden of pre-existing diagnoses of coronary heart disease (CHD) and stroke in people with bronchiectasis compared with the general population. The historical cohort study investigates if individuals with bronchiectasis are at increased risk of incident CHD and stroke events.
We used primary care electronic records from the Clinical Practice Research Datalink. The cross-sectional study used logistic regression to quantify the association between bronchiectasis and recorded diagnoses of CHD or stroke. Cox regression was used to investigate if people with bronchiectasis experienced increased incident CHD and strokes compared with the general population, adjusting for age, sex, smoking habit and other risk factors for cardiovascular disease.
Pre-existing diagnoses of CHD (OR 1.33, 95% CI 1.25 to 1.41) and stroke (OR 1.92, 95% CI 1.85 to 2.01) were higher in people with bronchiectasis compared with those without bronchiectasis, after adjusting for age, sex, smoking and risk factors for cardiovascular disease. The rate of first CHD and stroke were also higher in people with bronchiectasis (HR for CHD 1.44 (95% CI 1.27 to 1.63) and HR for stroke 1.71 (95% CI 1.54 to 1.90)).
The risk of CHD and stroke are higher among people with bronchiectasis compared with the general population. An increased awareness of these cardiovascular comorbidities in this population is needed to provide a more integrated approach to the care of these patients.
关于支气管扩张症患者心血管合并症负担的数据有限。我们的横断面研究估计了支气管扩张症患者与普通人群相比,既往冠心病(CHD)和中风诊断的负担。历史队列研究调查了支气管扩张症患者发生冠心病和中风事件的风险是否增加。
我们使用了来自临床实践研究数据链的初级保健电子记录。横断面研究使用逻辑回归来量化支气管扩张症与记录的冠心病或中风诊断之间的关联。Cox回归用于调查支气管扩张症患者与普通人群相比,发生冠心病和中风的风险是否增加,并对年龄、性别、吸烟习惯和其他心血管疾病风险因素进行了调整。
在调整年龄、性别、吸烟和心血管疾病风险因素后,支气管扩张症患者既往冠心病(OR 1.33,95%CI 1.25至1.41)和中风(OR 1.92,95%CI 1.85至2.01)的诊断率高于无支气管扩张症的患者。支气管扩张症患者首次发生冠心病和中风的发生率也更高(冠心病的HR为1.44(95%CI 1.27至1.63),中风的HR为1.71(95%CI 1.54至1.90))。
与普通人群相比,支气管扩张症患者患冠心病和中风的风险更高。需要提高对该人群这些心血管合并症的认识,以便为这些患者提供更综合的护理方法。