Department of Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, USA.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Sci Rep. 2021 Dec 14;11(1):23985. doi: 10.1038/s41598-021-03407-4.
Treatment options for several chronic infectious and inflammatory conditions have expanded in recent years. This may have implications for evolving competing risks for chronic inflammation-associated comorbidities, including cardiovascular diseases (CVDs). Yet sparse data exist on patterns over time in cardiovascular mortality for chronic infectious and inflammatory conditions. We used data from the Centers for Disease Control and Prevention 1999-2018 Multiple Causes of Death database to investigate patterns in CVD mortality from January 1, 1999 to December 31, 2018 in several infectious and inflammatory conditions. Specifically, we determined age-adjusted proportionate CVD mortality separately for patients with the following conditions (as well as the general population): hepatitis C virus (HCV), human immunodeficiency virus (HIV), inflammatory bowel diseases (IBD), psoriasis (PSO), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). Proportionate CVD mortality differed significantly in 1999 and 2018 for each condition compared with the general population (p < 0.0001). Proportionate CVD mortality decreased steadily in the general population (40.9 to 30.6%) but increased for patients with HCV (7.0 to 10.2%) and HIV (1.9 to 6.7%). For IBD, PSO, RA, and SLE, proportionate CVD mortality initially decreased followed by plateauing or increasing rates. Underlying disease-specific pathophysiologies, changes in natural history, and competing risks of chronic end-organ diseases contributing to these differences merit further study.
近年来，几种慢性感染性和炎症性疾病的治疗选择有所扩大。这可能对慢性炎症相关合并症（包括心血管疾病）的不断变化的竞争风险产生影响。然而，关于慢性感染性和炎症性疾病的心血管死亡率随时间变化的模式，数据仍然很少。我们使用美国疾病控制与预防中心 1999-2018 年多病因死亡数据库的数据，调查了 1999 年 1 月 1 日至 2018 年 12 月 31 日几种感染性和炎症性疾病的心血管死亡率模式。具体来说，我们确定了以下疾病（以及一般人群）的年龄调整后心血管死亡率的比例：丙型肝炎病毒（HCV）、人类免疫缺陷病毒（HIV）、炎症性肠病（IBD）、银屑病（PSO）、类风湿关节炎（RA）和系统性红斑狼疮（SLE）。与一般人群相比，每种疾病在 1999 年和 2018 年的心血管死亡率比例都有显著差异（p<0.0001）。一般人群的心血管死亡率稳步下降（从 40.9%降至 30.6%），但 HCV 患者（从 7.0%增至 10.2%）和 HIV 患者（从 1.9%增至 6.7%）的心血管死亡率则有所增加。对于 IBD、PSO、RA 和 SLE，心血管死亡率最初下降，随后趋于平稳或上升。这些差异源于疾病特异性病理生理学、自然病史变化以及导致慢性终末器官疾病的竞争风险，值得进一步研究。
