Luni Faraz Khan, Malik Sonia Ali, Khan Abdur Rahman, Riaz Haris, Singh Hemindermeet, Federman Douglas, Kanjwal Yusuf, Dasa Osama, Khuder Sadik, Kabour Ameer
Department of Cardiovascular Diseases, Mercy Saint Vincent Medical Center, Toledo, Ohio.
Department of Family Medicine, Mercy Saint Vincent Medical Center, Toledo, Ohio.
Am J Med Sci. 2017 Oct;354(4):395-398. doi: 10.1016/j.amjms.2017.05.001. Epub 2017 May 4.
Ischemic heart disease (IHD) has emerged as a major cause of morbidity and mortality in patients with autoimmune conditions such as systemic lupus erythematosus and rheumatoid arthritis, but the risk of IHD in Sjögren's syndrome (SjS) is unknown. To fill this knowledge gap, we estimated the prevalence and risk of IHD with SjS compared to controls from the general population using the Healthcare Cost and Utilization Project National Inpatient Sample 2011 database.
The Healthcare Cost and Utilization Project administrative longitudinal database contains encounter-level information on inpatient stays, emergency department visits and ambulatory surgery in all U.S. hospitals. We conducted a cross-sectional study among the inpatient population diagnosed with SjS and matched 1:4 with controls for age, sex and hospital region. Odds ratio for IHD was calculated as cases compared to controls. The contribution of various risk factors to IHD was also evaluated by logistic regression.
Analysis demonstrated that 7,154 of 13,086 cases (54.7%) of SjS had IHD compared to 27,367 of 52,448 controls (52.2%). The adjusted odds ratio for IHD in those with SjS was 0.898 (95% CI: 0.844-0.955). Patients with SjS were significantly more likely to have hypertension, diabetes, apnea and lipid disorders.
To our knowledge, this is the largest population-based study investigating the risk of IHD in patients with SjS. We found a modest, though statistically significant, decrease in the risk of IHD in SjS compared to controls.
缺血性心脏病(IHD)已成为系统性红斑狼疮和类风湿关节炎等自身免疫性疾病患者发病和死亡的主要原因,但干燥综合征(SjS)患者患IHD的风险尚不清楚。为填补这一知识空白,我们使用2011年医疗成本和利用项目全国住院患者样本数据库,估计了SjS患者与普通人群对照组相比患IHD的患病率和风险。
医疗成本和利用项目行政纵向数据库包含美国所有医院住院、急诊就诊和门诊手术的个体病例信息。我们对诊断为SjS的住院患者进行了一项横断面研究,并按年龄、性别和医院区域与对照组进行1:4匹配。计算IHD的比值比,以病例数与对照数进行比较。还通过逻辑回归评估了各种风险因素对IHD的影响。
分析表明,13086例SjS病例中有7154例(54.7%)患有IHD,而52448例对照中有27367例(52.2%)患有IHD。SjS患者IHD的调整后比值比为0.898(95%CI:0.844-0.955)。SjS患者患高血压、糖尿病、呼吸暂停和脂质紊乱的可能性显著更高。
据我们所知,这是调查SjS患者IHD风险的最大规模的基于人群的研究。我们发现,与对照组相比,SjS患者患IHD的风险虽有适度降低,但具有统计学意义。