Jacquet-Smailovic Murielle, Brennstuhl Marie-Jo, Tarquinio Camille Louise, Tarquinio Cyril
Department of Health Psychology, University of Lorraine, APEMAC/EPSAM EA 4360, Île du Saulcy, 57000 Metz, France.
Centre Hospitalier d'Avesnes, Unité de Réadaptation Cardiaque Et Vasculaire, Route de Haut-Lieu, 59363 Avesnes-sur-Helpe, France.
J Child Adolesc Trauma. 2021 Sep 22;15(3):701-714. doi: 10.1007/s40653-021-00404-7. eCollection 2022 Sep.
The aim of this systematic review and meta-analysis was to estimate the relationship between cumulative adverse childhood experiences (ACEs) and myocardial infarction (MI) in adulthood and to examine the role of potential confounding factors that may have contributed to the association. Studies examining the association of cumulative ACEs with MI among adults were identified by searching PubMed/MEDLINE, PsycINFO, ScienceDirect, and ProQuest Dissertations and Thesis. Individual estimates of odds ratios were pooled using random effects meta-analysis. Articles were pooled separately according to whether findings were adjusted for sociodemographic factors, cardiovascular disease (CVD) risk factors, and psychological factors. Several moderators were also examined: age, gender, race/ethnicity, type of MI assessment, type of cumulative ACEs assessment, and quality assessment of included studies. A total of 10 eligible studies met our inclusion criteria. The pooled ORs for the magnitude of the relationship between ACEs and MI were OR = 1.88; 95% CI, 1.40-2.53, before adjustment for CVD risk factors, and OR = 1.78; 95% CI, 1.24-2.57, after adjustment for CVD risk factors. The association between ACEs and MI was OR = 2.09; 95% CI, 1.43-3.06, after further adjustment for psychological factors. Effect sizes were larger when studies included participants predominantly over 55 years of age than younger participants. Cumulative ACEs is associated with an increased risk of MI in adulthood. However, further prospective studies are needed to better understand potential moderators that attenuate or amplify observed relations.
The online version contains supplementary material available at 10.1007/s40653-021-00404-7.
本系统评价和荟萃分析的目的是评估童年不良经历（ACEs）累积与成年后心肌梗死（MI）之间的关系，并探讨可能导致这种关联的潜在混杂因素的作用。通过检索PubMed/MEDLINE、PsycINFO、ScienceDirect和ProQuest学位论文数据库，确定了研究成年人群中累积ACEs与MI关联的研究。使用随机效应荟萃分析汇总个体比值比估计值。根据研究结果是否对社会人口学因素、心血管疾病（CVD）危险因素和心理因素进行了调整，将文章分别进行汇总。还考察了几个调节因素：年龄、性别、种族/民族、MI评估类型、累积ACEs评估类型以及纳入研究的质量评估。共有10项符合条件的研究满足我们的纳入标准。在未调整CVD危险因素之前，ACEs与MI之间关系强度的合并OR值为OR = 1.88；95%CI为1.40 - 2.53，在调整CVD危险因素之后，OR = 1.78；95%CI为1.24 - 2.57。在进一步调整心理因素之后，ACEs与MI之间的关联为OR = 2.09；95%CI为1.43 - 3.06。当研究主要纳入55岁以上参与者而非年轻参与者时，效应量更大。累积ACEs与成年后MI风险增加相关。然而，需要进一步的前瞻性研究来更好地理解减弱或增强观察到的关系的潜在调节因素。
在线版本包含可在10.1007/s40653-021-00404-7获取的补充材料。
