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多发性硬化症患者的心血管疾病事件:一项多数据库研究。

Incident cardiovascular disease in patients diagnosed with multiple sclerosis: A multi-database study.

机构信息

Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.

Celgene Corporation, Summit, NJ, USA.

出版信息

Mult Scler Relat Disord. 2020 Jan;37:101423. doi: 10.1016/j.msard.2019.101423. Epub 2019 Oct 1.

Abstract

BACKGROUND

Recent data on rates of cardiovascular disease (CVD) in patients after MS diagnosis are sparse.

OBJECTIVE

To describe incident CVD in MS patients after diagnosis compared with a matched non-MS population.

METHODS

We conducted a matched cohort study in two separate electronic medical databases, the United States Department of Defense military health care system and the United Kingdom's Clinical Practice Research Datalink GOLD. The study population included all patients with a first recorded diagnosis of MS and no history of CVD or selected measurable comorbidities associated with CVD and matched non-MS patients who were also free of CVD and the CVD associated comorbidities. We identified incident CVD outcomes first recorded after the MS diagnosis / matched date and calculated incidence rates and incidence rate ratios by type of CVD.

RESULTS

Rates of venous thromboembolism and peripheral vascular disease were 2-fold higher among MS than non-MS patients in both databases and the risk of myocardial infarction was 2.5 times higher among female MS patients compared with non-MS females in both databases. Other CVD outcomes were not consistent between databases.

CONCLUSION

MS patients in the UK and the US have increased risk of venous thromboembolism and peripheral vascular disease. The risk of myocardial infarction is increased among female MS patients.

摘要

背景

最近有关多发性硬化症(MS)患者心血管疾病(CVD)发生率的数据较为匮乏。

目的

描述 MS 患者在确诊后发生 CVD 的情况,并与匹配的非 MS 人群进行比较。

方法

我们在两个独立的电子医疗数据库中开展了一项匹配队列研究,即美国国防部医疗保健系统和英国临床实践研究数据链接 GOLD。研究人群包括首次记录有 MS 诊断且无 CVD 或与 CVD 相关的可测量合并症病史,以及未患有 CVD 且无 CVD 相关合并症的匹配非 MS 患者。我们首先在 MS 确诊/匹配日期后记录首次出现的 CVD 结局,并按 CVD 类型计算发生率和发生率比值。

结果

在两个数据库中,MS 患者的静脉血栓栓塞和外周血管疾病发生率均是非 MS 患者的 2 倍,且在两个数据库中,女性 MS 患者的心肌梗死风险是非 MS 女性患者的 2.5 倍。其他 CVD 结局在两个数据库之间并不一致。

结论

英国和美国的 MS 患者发生静脉血栓栓塞和外周血管疾病的风险增加。女性 MS 患者发生心肌梗死的风险增加。

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