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COPD 与心血管疾病风险增加相关,而与表型无关。

COPD is associated with increased cardiovascular disease risk independent of phenotype.

机构信息

Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, USA.

Division of Epidemiology, Virginia Commonwealth University, Richmond, Virginia, USA.

出版信息

Respirology. 2024 Dec;29(12):1047-1057. doi: 10.1111/resp.14799. Epub 2024 Jul 17.

Abstract

BACKGROUND AND OBJECTIVE

Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide that frequently presents with concomitant cardiovascular diseases. Despite the pathological distinction between individual COPD phenotypes such as emphysema and chronic bronchitis, there is a lack of knowledge about the impact of COPD phenotype on cardiovascular disease risk. Thus, this study aimed to utilize a nationally representative sample to investigate cardiovascular disease prevalence in patients with COPD with emphysema and chronic bronchitis phenotypes.

METHODS

Data from 31,560 adults including 2504 individuals with COPD, collected as part of the National Health and Nutrition Examination Survey (1999-2018), were examined.

RESULTS

A significantly increased cardiovascular disease risk, including coronary heart disease, heart failure, myocardial infarction and stroke, was identified in patients with COPD among all disease phenotypes. Particularly, compared to those without COPD, individuals with chronic bronchitis presented with 1.76 (95% CI: 1.41-2.20) times greater odds, individuals with emphysema with 2.31 (95% CI: 1.80-2.96) times greater odds, while those with a concurrent phenotype (combined chronic bronchitis and emphysema) exhibited 2.98 (95% CI: 2.11-4.21) times greater odds of reporting cardiovascular diseases.

CONCLUSION

Our data confirms that patients with COPD present an elevated risk of developing cardiovascular disease among all phenotypes, with the most marked increase being in those with concurrent chronic bronchitis and emphysema phenotypes. These findings emphasize the need for awareness and appropriate cardiovascular screening in COPD.

摘要

背景与目的

慢性阻塞性肺疾病(COPD)是全球主要致死病因之一,常伴有心血管疾病。尽管 COPD 存在肺气肿和慢性支气管炎等不同表型,但对于 COPD 表型对心血管疾病风险的影响知之甚少。因此,本研究旨在利用全国代表性样本,调查肺气肿和慢性支气管炎表型 COPD 患者的心血管疾病患病率。

方法

对作为全国健康和营养调查(1999-2018 年)一部分的 31560 名成年人的数据进行了检查,其中包括 2504 名 COPD 患者。

结果

在所有疾病表型中,COPD 患者的心血管疾病风险显著增加,包括冠心病、心力衰竭、心肌梗死和中风。特别是,与无 COPD 患者相比,慢性支气管炎患者的心血管疾病风险增加 1.76 倍(95%CI:1.41-2.20),肺气肿患者增加 2.31 倍(95%CI:1.80-2.96),同时具有合并表型(慢性支气管炎和肺气肿同时存在)的患者则增加 2.98 倍(95%CI:2.11-4.21)。

结论

我们的数据证实,所有表型的 COPD 患者发生心血管疾病的风险均升高,其中并发慢性支气管炎和肺气肿的患者风险增加最为显著。这些发现强调了在 COPD 患者中提高认识和进行适当心血管筛查的必要性。

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