Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77, Stockholm, Sweden.
Centre for Digestive Health, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
Esophagus. 2024 Jul;21(3):365-373. doi: 10.1007/s10388-024-01066-8. Epub 2024 May 29.
Inflammatory diseases have been associated with an increased cardiovascular risk. However, data on incident major adverse cardiovascular events (MACE) from large population-based cohorts of patients with eosinophilic esophagitis (EoE) is lacking.
This study included all Swedish adults with EoE without a record of previous cardiovascular disease (CVD) (1990-2017, N = 1546) with follow-up until 2019. Individuals with EoE were identified from prospectively recorded histopathology reports from all Swedish pathology departments (n = 28). EoE patients were matched at index date for age, sex, calendar year and county with up to five general population reference individuals (N = 7281) without EoE or CVD. Multivariable-adjusted hazard ratios (aHRs) for MACE (ischemic heart disease, congestive heart failure, stroke and cardiovascular mortality) were calculated using Cox proportional hazards models. Full sibling comparisons and adjustment for cardiovascular medication were performed.
During a median follow-up of 6.0 years, we observed 65 incident MACE in patients with EoE (6.4/1000 person-years (PY)) and 225 in reference individuals (4.7/1000 PY). EoE was not associated with a higher risk of MACE (aHR = 1.14, 95% CI = 0.86-1.51) or any of its components. No differences between age, sex and follow-up time were observed. The results remained stable in sensitivity analyses, including when adjusting for relevant cardiovascular medications and a full sibling comparison.
In this large population-based cohort study, patients with EoE had no increased risk of MACE compared to reference individuals and full siblings. The results are reassuring for patients with EoE.
炎症性疾病与心血管风险增加相关。然而，缺乏嗜酸细胞性食管炎（EoE）大人群队列中发生主要不良心血管事件（MACE）的相关数据。
本研究纳入了所有无既往心血管疾病（CVD）病史的瑞典成年 EoE 患者（1990-2017 年，N=1546），随访至 2019 年。所有瑞典病理科的前瞻性记录组织病理学报告中均识别到 EoE 患者（n=28）。EoE 患者在索引日期时按照年龄、性别、日历年度和县与多达 5 名无 EoE 或 CVD 的一般人群参考个体（N=7281）进行匹配。使用 Cox 比例风险模型计算 MACE（缺血性心脏病、充血性心力衰竭、中风和心血管死亡率）的多变量调整危险比（aHR）。进行了全同胞比较和心血管药物调整。
在中位随访 6.0 年期间，我们观察到 EoE 患者中有 65 例发生 MACE（6.4/1000 人年（PY）），参考个体中有 225 例发生 MACE（4.7/1000 PY）。EoE 与 MACE 风险增加无关（aHR=1.14，95%CI=0.86-1.51）或任何组成部分。未观察到年龄、性别和随访时间之间的差异。在包括调整相关心血管药物和全同胞比较的敏感性分析中，结果仍然稳定。
在这项大型基于人群的队列研究中，与参考个体和全同胞相比，EoE 患者发生 MACE 的风险没有增加。结果令人安心。
