Department of Cardiology, Shanghai Songjiang District Central Hospital, Shanghai, China.
Division of Cardiovascular Diseases, Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Hongkou District, Shanghai, 200080, China.
Cardiovasc Diabetol. 2023 Sep 30;22(1):268. doi: 10.1186/s12933-023-01987-1.
Previous studies have reported that inflammatory responses can promote the onset of cardiovascular diseases; however, its association with cardiac conduction disorders remains unclear. The present community-based cohort study aimed to elucidate the effects of inflammatory responses on the risk of developing cardiac conduction disorders.
After the exclusion of participants failing to meet the inclusion criteria, 86,234 eligible participants (mean age: 50.57 ± 11.88 years) were included. The participants were divided into high-sensitivity C-reactive protein (hsCRP) ≤ 3 mg/L, and hsCRP > 3 mg/L groups based on hsCRP values. Multivariate Cox proportional hazard model was used to analyze the relationship between inflammatory responses and various cardiac conduction disorders.
After adjusting for confounding factors, we observed that compared with the hsCRP ≤ 3 mg/L group, the hsCRP > 3 mg/L group exhibited increased risks of atrioventricular block (hazard ratio [HR]:1.64, 95%confidence interval [CI] 1.44-1.87) and left (HR:1.25, 95% CI 1.07-1.45) and right bundle branch block (HR:1.31, 95% CI 1.17-1.47). Moreover, the risk of various cardiac conduction disorders increased for every 1 standard deviation increase in log (hsCRP). The restricted cubic spline function confirmed a linear relationship between log (hsCRP) and the risk of developing cardiac conduction disorders (All nonlinearity P > 0.05).
High hsCRP levels are an independent risk factor for cardiac conduction disorders, and hsCRP levels are dose-dependently associated with the risk of conduction disorders. Our study results may provide new strategies for preventing cardiac conduction disorders.
既往研究报道炎症反应可促进心血管疾病的发生,但炎症反应与心脏传导障碍的关系尚不清楚。本基于社区的队列研究旨在阐明炎症反应对心脏传导障碍发生风险的影响。
排除不符合纳入标准的参与者后,共纳入 86234 名符合条件的参与者(平均年龄:50.57±11.88 岁)。根据 hsCRP 值将参与者分为高敏 C 反应蛋白(hsCRP)≤3mg/L 和 hsCRP>3mg/L 组。采用多变量 Cox 比例风险模型分析炎症反应与各种心脏传导障碍之间的关系。
调整混杂因素后,与 hsCRP≤3mg/L 组相比,hsCRP>3mg/L 组发生房室传导阻滞(风险比[HR]:1.64,95%置信区间[CI]:1.44-1.87)、左束支传导阻滞(HR:1.25,95%CI:1.07-1.45)和右束支传导阻滞(HR:1.31,95%CI:1.17-1.47)的风险增加。此外,log(hsCRP)每增加 1 个标准差,各种心脏传导障碍的风险就会增加。限制立方样条函数确认 log(hsCRP)与发生心脏传导障碍的风险之间存在线性关系(所有非线性 P>0.05)。
高 hsCRP 水平是心脏传导障碍的独立危险因素,hsCRP 水平与传导障碍的风险呈剂量依赖性相关。我们的研究结果可能为预防心脏传导障碍提供新策略。