化脓性汗腺炎患者心血管疾病发病风险：一项大规模、倾向评分匹配的全球回顾性队列研究。

Risk of cardiovascular disorders in hidradenitis suppurativa patients: a large-scale, propensity-matched global retrospective cohort study.

机构信息

Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.

Comprehensive Center for Inflammation Medicine, University-Hospital Schleswig-Holstein, Lübeck, Germany.

出版信息

Int J Dermatol. 2024 Jun;63(6):799-805. doi: 10.1111/ijd.17186. Epub 2024 Apr 21.

DOI:10.1111/ijd.17186

PMID:38644522

Abstract

BACKGROUND

Patients with hidradenitis suppurativa (HS) often suffer from comorbid diabetes, metabolic syndrome, and hyperlipidemia and, therefore, are susceptible to the development of cardiovascular diseases (CVDs). Moreover, systemic inflammation plays a vital role in the development of atherosclerosis. The creation of atherosclerotic plaque is characterized by endothelial dysfunction driven by elevated concentrations of interleukin (IL)-1, IL-6, and IL-18 among others, as well as tumor necrosis factor (TNF) alpha.

METHODS

This study aimed to assess the risk of HS patients developing CVDs. We performed a large-scale, propensity-matched global retrospective cohort study analyzing the risk of development of CVDs in patients suffering from HS. The analysis included 144,100 HS patients with 144,100 healthy controls (HC). The cohorts were matched regarding demographics and history of diseases relevant to CVDs, e.g., diabetes, obesity, and nicotine dependence. A total of 90 cardiovascular disorders were identified. The identification of cardiovascular disorders was based on ≥1% appearance of the event, based on absolute numbers, in both cohorts.

RESULTS

Before the matching, HS patients displayed a higher frequency in excess weight or obesity (25 vs. 14.4%, respectively), nicotine dependence, and diabetes mellitus, but lower odds of primary hypertension in comparison to healthy controls. A total of 47 CVDs are associated with an increased risk of onset in HS patients. Although the highest hazard ratio (HR; 2.1; 95% CI: 1.95-2.269) was found for unspecified heart failure, the HS cohort was exceptionally predisposed to developing myocardial infarction (HR: 2.06; 95% CI: 1.88-2.27) and an acute embolism and deep vein thrombosis of the lower extremity (HR: 1.93; 95% CI: 1.74-2.14).

CONCLUSIONS

This is the most extensive study on the association of HS with CVDs. We demonstrated that HS patients are at significantly greater risk of developing various CVDs compared to matched controls, with heart failure being the most common one.

摘要

背景

患有化脓性汗腺炎（HS）的患者常伴有合并症，如糖尿病、代谢综合征和高脂血症，因此易患心血管疾病（CVD）。此外，全身炎症在动脉粥样硬化的发展中起着至关重要的作用。动脉粥样硬化斑块的形成特征是内皮功能障碍，由白细胞介素（IL）-1、IL-6 和 IL-18 等浓度升高以及肿瘤坏死因子（TNF）alpha 驱动。

方法

本研究旨在评估 HS 患者发生 CVD 的风险。我们进行了一项大规模的、基于倾向评分的全球回顾性队列研究，分析了患有 HS 的患者发生 CVD 的风险。该分析包括 144100 名 HS 患者和 144100 名健康对照（HC）。这些队列在与 CVD 相关的疾病的人口统计学和病史方面进行了匹配，例如糖尿病、肥胖和尼古丁依赖。共确定了 90 种心血管疾病。心血管疾病的识别是基于两个队列中基于事件的绝对数量，≥1%的出现。

结果

在匹配之前，HS 患者超重或肥胖的发生率（分别为 25%和 14.4%）、尼古丁依赖和糖尿病的发生率较高，但原发性高血压的发生率较低。共有 47 种 CVD 与 HS 患者发病风险增加相关。尽管未指定的心力衰竭的风险比（HR）最高（2.1；95%置信区间：1.95-2.269），但 HS 队列特别容易发生心肌梗死（HR：2.06；95%置信区间：1.88-2.27）和下肢急性栓塞和深静脉血栓形成（HR：1.93；95%置信区间：1.74-2.14）。