Department of Rheumatology and Immunology, Nanchong Central Hospital, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong Hospital of Beijing Anzhen Hospital Capital Medical University, Nanchong, Sichuan, China.
School of Basic Medicine, Southwest Medical University, Luzhou, Sichuan, China.
Autoimmun Rev. 2024 Oct;23(10):103614. doi: 10.1016/j.autrev.2024.103614. Epub 2024 Aug 31.
We performed a systematic review and meta-analysis to assess whether patients with connective tissue disease (CTD)-associated interstitial lung diseases (ILD) have an increased prevalence of cardiovascular (CV) disease and to validate associated risk factors.
The PRISMA guidelines and PICO model were followed. We searched PubMed, Embase, Cochrane Library databases, Scopus, and Directory of Open Access Journals from inception to April 2024.
Thirteen studies comprising of 12,520 patients were included. Patients with CTD-ILD had a significantly increased risk of CV disease than patients with CTD (relative risk [RR] = 1.65, 95 % confidence interval [CI]: 1.41, 1.93), which are related to the proportion of men (P = 0.001) and the proportion of smokers (P = 0.045). Subgroup analysis found that patients with CTD-ILD had a higher risk of heart failure (RR = 2.84, 95 % CI: 1.50, 5.39), arrhythmia (RR = 1.55, 95 % CI: 1.22, 1.97) than patients with CTD. Another subgroup analysis showed that RA-ILD and SSc-ILD were associated with an increased risk of CV disease, but not IIM-ILD and MCTD-ILD (RA-ILD: RR = 2.19, 95 % CI: 1.27, 3.80; SSc-ILD: RR = 1.53, 95 % CI: 1.29, 1.82). Besides, patients with CTD-ILD had a higher prevalence of pulmonary arterial hypertension (RR = 2.48, 95 % CI: 1.69, 3.63) than patients with CTD.
Patients with CTD-ILD had a 1.65 times increased risk of CV than patients with CTD-non-ILD, with increased prevalence of heart failure and arrhythmia. The risk of CV disease in SSc-ILD and RA-ILD is increased and we should pay more attention to male smokers. In addition, compared with CTD patients, CTD-ILD patients had a higher risk of pulmonary arterial hypertension.
我们进行了系统评价和荟萃分析，以评估结缔组织病（CTD）相关间质性肺病（ILD）患者是否存在心血管（CV）疾病患病率增加，并验证相关风险因素。
遵循 PRISMA 指南和 PICO 模型。我们检索了 PubMed、Embase、Cochrane 图书馆数据库、Scopus 和开放获取期刊目录，从成立到 2024 年 4 月。
纳入了 13 项包含 12520 名患者的研究。与 CTD 患者相比，CTD-ILD 患者 CV 疾病的风险显著增加（相对风险 [RR] 1.65，95%置信区间 [CI]：1.41，1.93），这与男性比例（P=0.001）和吸烟者比例（P=0.045）有关。亚组分析发现，CTD-ILD 患者心力衰竭（RR 2.84，95%CI：1.50，5.39）和心律失常（RR 1.55，95%CI：1.22，1.97）的风险高于 CTD 患者。另一项亚组分析表明，RA-ILD 和 SSc-ILD 与 CV 疾病风险增加相关，但 IIM-ILD 和 MCTD-ILD 则不然（RA-ILD：RR 2.19，95%CI：1.27，3.80；SSc-ILD：RR 1.53，95%CI：1.29，1.82）。此外，与 CTD 患者相比，CTD-ILD 患者肺动脉高压（RR 2.48，95%CI：1.69，3.63）的患病率更高。
与 CTD-ILD 患者相比，CTD-ILD 患者发生 CV 疾病的风险增加了 1.65 倍，心力衰竭和心律失常的发生率也有所增加。SSc-ILD 和 RA-ILD 的 CV 疾病风险增加，我们应更加关注男性吸烟者。此外，与 CTD 患者相比，CTD-ILD 患者发生肺动脉高压的风险更高。
