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秋水仙碱治疗痛风患者的冠状动脉疾病风险:一项系统评价和荟萃分析。

Risk of coronary artery disease in patients with gout on treatment with Colchicine: A systematic review and meta-analysis.

作者信息

Siddiqui Muhammad U, Junarta Joey, Sathyanarayanan Swaminathan, Kochar Kirpal, Ullah Waqas, Fischman David L

机构信息

Jefferson Heart Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Division of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

出版信息

Int J Cardiol Heart Vasc. 2023 Mar 4;45:101191. doi: 10.1016/j.ijcha.2023.101191. eCollection 2023 Apr.

Abstract

BACKGROUND

Colchicine has anti-inflammatory properties, but its utility in improving cardiovascular outcomes has been disputed. Here, we study the impact of colchicine on cardiovascular outcomes in patients with gout with and without coronary artery disease (CAD).

METHODS

Medline, Web of Science and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Primary outcomes included myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Secondary outcomes included stroke and all-cause mortality.

RESULTS

We included 4 observational studies comprising 10,026 patients with gout on treatment with colchicine. There was no significant difference in the risk of myocardial infarction (risk ratio [RR] 0.71; 95% confidence interval [CI], 0.36-1.39), need for PCI, or need for CABG, between patients on colchicine and those not receiving colchicine. Colchicine was associated with a significantly lower risk of all-cause mortality (RR 0.58; 95% CI 0.43-0.79).

CONCLUSION

Non-randomized studies suggest that risk of MI, stroke and revascularization is not higher in gout patients treated with colchicine compared to gout patients without colchicine treatment.

摘要

背景

秋水仙碱具有抗炎特性,但其在改善心血管结局方面的效用一直存在争议。在此,我们研究秋水仙碱对合并和不合并冠状动脉疾病(CAD)的痛风患者心血管结局的影响。

方法

系统检索Medline、科学网和Cochrane对照试验中央注册库以识别相关研究。主要结局包括心肌梗死(MI)、经皮冠状动脉介入治疗(PCI)和冠状动脉旁路移植术(CABG)。次要结局包括中风和全因死亡率。

结果

我们纳入了4项观察性研究,共10,026例接受秋水仙碱治疗的痛风患者。服用秋水仙碱的患者与未接受秋水仙碱治疗的患者相比,心肌梗死风险(风险比[RR]0.71;95%置信区间[CI],0.36 - 1.39)、PCI需求或CABG需求无显著差异。秋水仙碱与显著更低的全因死亡率风险相关(RR 0.58;95% CI 0.43 - 0.79)。

结论

非随机研究表明,与未接受秋水仙碱治疗的痛风患者相比,接受秋水仙碱治疗的痛风患者发生MI、中风和血运重建的风险并不更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c788/10009207/95ba0d1a55d5/gr1.jpg

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