Tang Manyun, Wang Yidan, Wang Mengjie, Tong Rui, Shi Tao
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Geriatric Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Pharmacol. 2021 Oct 26;12:767982. doi: 10.3389/fphar.2021.767982. eCollection 2021.
Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases. To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS. This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality. Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all < 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050-1.543); = 0.014], hypertension [aHR: 2.006 (1.005-4.004); = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335-17.079); = 0.016] and heart failure [aHR: 3.067 (1.521-6.185); = 0.002] were found to be independent risk factors for 1-year all-cause mortality. Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.
患有慢性阻塞性肺疾病(COPD)和阻塞性睡眠呼吸暂停(OSAS)重叠综合征(OS)的患者被认为患心血管疾病的风险增加。为了评估OS患者的心血管疾病负担和长期预后。这是一项回顾性队列研究。比较了诊断为OS的患者(OS组)、单纯COPD患者(COPD组)和单纯OSAS患者(OSAS组)的心血管疾病患病率和1年死亡率,并使用Cox比例风险模型评估全因死亡率的独立危险因素。总体而言,OS患者比COPD或OSAS患者患肺动脉高压(PH)、心力衰竭和全因死亡率的风险更高(均P<0.05)。在多变量Cox回归分析中,查尔森合并症指数(CCI)评分[调整后风险比(aHR):1.273(1.050-1.543);P=0.014]、高血压[aHR:2.006(1.005-4.004);P=0.048]、肺血栓栓塞(PTE)[aHR:4.774(1.335-17.079);P=0.016]和心力衰竭[aHR:3.067(1.521-6.185);P=0.002]被发现是1年全因死亡率的独立危险因素。OS患者患心血管疾病和1年死亡率的风险增加。需要更多努力来确定OS与心血管疾病之间的因果关系,促进这些患者的风险分层和管理。