非呼吸暂停性睡眠障碍与心力衰竭事件风险增加相关——一项全国范围内基于人群的队列研究。
Non-Apnea Sleep Disorder associates with increased risk of incident heart failure-A nationwide population-based cohort study.
机构信息
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
出版信息
PLoS One. 2019 Jan 16;14(1):e0209673. doi: 10.1371/journal.pone.0209673. eCollection 2019.
PURPOSE
Non-apnea sleep disorder (NASD) increases the risk of cardiovascular events, such as hypertension and ischemic heart disease (IHD). Patients with heart failure (HF) are at higher risk for sleep disorder; however, there is no documentation on NASD's association with HF to date. Therefore, our study aimed to determine whether NASD increases the risk of incident HF.
MATERIALS AND METHODS
Using the outpatient and inpatient data from Taiwan's Longitudinal Health Insurance Database, we conducted a nationwide cohort study of patients with a first-time diagnosis of NASD in the year 2000 and followed up the risk of incident heart failure until December 31, 2013. We calculated risks and incidence ratios of HF for patients with NASD compared with the general population. The cumulative incidence of NASD and the subsequent risk of HF are assessed by the Kaplan-Meier method and Cox regression using a matched comparison cohort of HF patients without NASD.
RESULTS
The NASD cohort had an adjusted hazard ratio (HR) of incident HF 19.7% higher than that of the cohort without NASD (95% CI = 1.130-1.270; p<0.001). In the NASD population, the mean interval to HF in males and females were 5.00±3.69 years and 5.00±3.66 years, respectively. The Kaplan-Meier analysis indicated that after the seventh year, the incidence of HF was higher in the NASD cohort than in the control cohort till the end of the follow up.
CONCLUSIONS
Our study demonstrates that NASD patients are associated with a higher risk of incident HF.
目的
非呼吸暂停性睡眠障碍（NASD）会增加心血管事件的风险，如高血压和缺血性心脏病（IHD）。心力衰竭（HF）患者患睡眠障碍的风险更高；然而，迄今为止，尚无关于 NASD 与 HF 之间关联的记录。因此，我们的研究旨在确定 NASD 是否会增加发生 HF 的风险。
材料和方法
我们使用来自台湾地区纵向健康保险数据库的门诊和住院数据，对 2000 年首次诊断为 NASD 的患者进行了全国性队列研究，并随访了直至 2013 年 12 月 31 日发生 HF 的风险。我们计算了患有 NASD 的患者与普通人群相比 HF 的风险和发病率比。通过 Kaplan-Meier 方法和 Cox 回归使用 HF 患者无 NASD 的匹配对照队列来评估 NASD 的累积发生率和随后的 HF 风险。
结果
NASD 队列发生 HF 的调整后的危险比（HR）比无 NASD 队列高 19.7%（95% CI = 1.130-1.270；p<0.001）。在 NASD 人群中，男性和女性发生 HF 的平均间隔分别为 5.00±3.69 年和 5.00±3.66 年。Kaplan-Meier 分析表明，在第七年后，NASD 队列的 HF 发生率高于对照组，直至随访结束。
结论
我们的研究表明，NASD 患者发生 HF 的风险更高。
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