Cereja Fátima, Alves Mariana, Ferreira Joaquim J, Caldeira Daniel
Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Serviço de Medicina III, Hospital Pulido Valente (CHULN), Lisboa, Portugal.
J Thromb Thrombolysis. 2023 May;55(4):747-750. doi: 10.1007/s11239-023-02792-z. Epub 2023 Mar 25.
The association of Parkinson's Disease (PD) with atrial fibrillation (AF) is not well established and previous studies' results were heterogeneous. This review aimed to evaluate if patients with PD are at increased risk of having AF. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, were searched from inception May 2021. Two reviewers independently selected observational studies with data allowing to estimate the risk of atrial fibrillation in PD patients compared with no-PD controls. Pooled estimates Odds Ratio (OR) and 95% confidence intervals (CIs) were derived through meta-analysis. Heterogeneity was assessed using I test. The risk of bias of individual studies was evaluated using the ROBINS-I tool. The study protocol was registered at PROSPERO: CRD42020216572. Seven studies were included: five case-control studies and two cohort studies. Three of the studies included were a population-based study. No significant difference was detected between PD and controls regarding atrial fibrillation (OR 1.10, 95% CI 0.81 to 1.49). Early PD present a significant higher risk of AF (OR 1.55, 95% CI 1.00 to 2.40, I 98%). The overall risk of bias was serious, with only two studies being considered as having moderate risk. The best evidence available do not support that there is an increased risk of AF in PD patients. Further studies are needed to better conclude if there is a relation between AF and PD.
帕金森病（PD）与心房颤动（AF）之间的关联尚未明确确立，先前研究的结果也存在异质性。本综述旨在评估帕金森病患者发生心房颤动的风险是否增加。检索了自2021年5月开始的MEDLINE、Cochrane对照试验中心注册库（CENTRAL）和科学网。两名 reviewers 独立选择了观察性研究，这些研究的数据能够估计帕金森病患者与非帕金森病对照相比发生心房颤动的风险。通过荟萃分析得出合并估计比值比（OR）和95%置信区间（CIs）。使用I²检验评估异质性。使用ROBINS-I工具评估单个研究的偏倚风险。该研究方案已在PROSPERO注册：CRD42020216572。纳入了七项研究：五项病例对照研究和两项队列研究。其中三项研究为基于人群的研究。在心房颤动方面，帕金森病患者与对照组之间未检测到显著差异（OR 1.10，95% CI 0.81至1.49）。早期帕金森病患者发生心房颤动的风险显著更高（OR 1.55，95% CI 1.00至2.40，I² 98%）。总体偏倚风险严重，只有两项研究被认为具有中度风险。现有最佳证据不支持帕金森病患者发生心房颤动的风险增加。需要进一步研究以更好地确定心房颤动与帕金森病之间是否存在关联。
