Figueira Gonçalves J M, García Bello M A, Martín Martínez M D, García-Talavera I, Mesa Fumero J, García Hernández S, Bethencourt Martín N, Díaz Pérez D, Afonso Díaz A
Servicio de Neumología y Cirugía Torácica, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España.
División de Epidemiología Clínica y Bioestadística, Unidad de Investigación, Hospital Universitario Nuestra Señora de la Candelaria y Gerencia de Atención Primaria, Santa Cruz de Tenerife, España.
Rev Clin Esp (Barc). 2020 Jun-Jul;220(5):267-274. doi: 10.1016/j.rce.2019.05.018. Epub 2019 Nov 6.
Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification.
A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij).
A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, P=.0054), chronic kidney disease (CKD) (RRij 1.34, P=.00023), and peripheral arterial disease (PAD) (RRij 1.38, P=.00015). AHT was mostly related to CVA (RRij 1.41, P=.0014) and CKD (RRij 1.42, P<.0001). Type 2 diabetes mellitus (T2DM) correlated with PAD (RRij 1.90, P=.0001), heart failure (HF) (RRij 1,74, P=.0002), and CKD (RRij 1.76, P<.0001), and obesity was associated with HF (RRij 1.60, P=.0009) and CKD (RRij 1.54, P=.0001).
DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA.
心血管疾病对慢性阻塞性肺疾病(COPD)患者的重要预后有负面影响,其中血脂异常(DLP)和动脉高血压(AHT)被认为是最常见的危险因素。本研究的目的是:1)评估COPD患者中已诊断的DLP与心血管疾病之间的关系,并将其与其他已知的心血管危险因素进行比较;2)根据GOLD 2017分类确定不同心血管合并症与严重程度组之间的关系。
对454例COPD门诊患者进行随访,开展一项横断面观察性研究。我们计算了每种心血管合并症的患病率以及每种心血管危险因素与血管疾病共同发生的概率(RRij)。
共有66.7%的患者存在DLP,其中DLP与脑血管意外(CVA)(RRij 1.36,P = 0.0054)、慢性肾脏病(CKD)(RRij 1.34,P = 0.00023)和外周动脉疾病(PAD)(RRij 1.38,P = 0.00015)相关。AHT主要与CVA(RRij 1.41,P = 0.0014)和CKD(RRij 1.42,P < 0.0001)相关。2型糖尿病(T2DM)与PAD(RRij 1.90,P = 0.0001)、心力衰竭(HF)(RRij 1.74,P = 0.0002)和CKD(RRij 1.76,P < 0.0001)相关,肥胖与HF(RRij 1.60,P = 0.0009)和CKD(RRij 1.54,P = 0.0001)相关。
DLP与CVA、CKD和PAD相关。AHT和T2DM是与HF和CVA关系最为密切的病症。