Qin Li, Li Fang, Luo Qiang, Chen Lifang, Yang Xiaoqian, Wang Han
Department of Cardiology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Department of Rheumatology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Front Med (Lausanne). 2022 Jan 14;8:808915. doi: 10.3389/fmed.2021.808915. eCollection 2021.
It is well-established that the association between atherosclerotic cardiovascular diseases (ASCVD) and connective tissue diseases (CTDs), but the relationship between coronary heart disease (CHD) and idiopathic inflammatory myopathies (IIMs) remains controversial yet. The aim of this meta-analysis is to systematically evaluate the risk of CHD in IIMs patients. In addition, we explore differences in traditional cardiovascular risk factors between IIMs patients and controls.
We searched Pubmed, EMBASE and Cochrane databases to identify relevant observational studies published in English up to August 2021. Pooled relative risk (RR) and 95% confidence interval (CI) was calculated using the generic inverse variance method for the risk of CHD. A meta-proportion analysis was conducted to assess differences in cardiovascular risk factors between two groups.
A total of 15 studies met inclusion criteria: seven studies focused on CHD and nine studies focused on traditional cardiovascular risk factors. The results demonstrated that IIMs patients had a higher risk of CHD (RR = 2.19, 95% CI: 1.40-3.42). Hypertension (OR = 1.44, 95% CI: 1.28-1.61), diabetes mellitus (OR = 1.67, 95% CI: 1.55-1.81) and dyslipidemia (OR = 1.48, 95% CI: 1.19-1.84) were more prevalent in IIMs patients compared with controls. However, there was a significant heterogeneity among studies assessing the risk of CHD and hypertension. Subgroup analysis demonstrated that definition of CHD, country and sample size may be potential sources of heterogeneity.
IIMs patients were at increased risk of CHD, and traditional cardiovascular risk factors appeared more prevalent in IIMs patients. This systemic review offers the proof that early appropriate interventions could reduce cardiovascular-associated morbidity and mortality in IIMs patients.
动脉粥样硬化性心血管疾病（ASCVD）与结缔组织病（CTD）之间的关联已得到充分证实，但冠心病（CHD）与特发性炎性肌病（IIM）之间的关系仍存在争议。本荟萃分析的目的是系统评估IIM患者患CHD的风险。此外，我们探讨IIM患者与对照组在传统心血管危险因素方面的差异。
我们检索了PubMed、EMBASE和Cochrane数据库，以识别截至2021年8月发表的相关英文观察性研究。使用通用逆方差法计算CHD风险的合并相对风险（RR）和95%置信区间（CI）。进行荟萃比例分析以评估两组之间心血管危险因素的差异。
共有15项研究符合纳入标准：7项研究关注CHD，9项研究关注传统心血管危险因素。结果表明，IIM患者患CHD的风险更高（RR = 2.19，95% CI：1.40 - 3.42）。与对照组相比，高血压（OR = 1.44，95% CI：1.28 - 1.61）、糖尿病（OR = 1.67，95% CI：1.55 - 1.81）和血脂异常（OR = 1.48，95% CI：1.19 - 1.84）在IIM患者中更为普遍。然而，在评估CHD和高血压风险的研究之间存在显著异质性。亚组分析表明，CHD的定义、国家和样本量可能是异质性的潜在来源。
IIM患者患CHD的风险增加，传统心血管危险因素在IIM患者中似乎更为普遍。这项系统评价提供了证据，表明早期适当干预可以降低IIM患者心血管相关的发病率和死亡率。
