Sá-Sousa Ana, Rodrigues Cidália, Jácome Cristina, Cardoso João, Fortuna Inês, Guimarães Miguel, Pinto Paula, Sarmento Pedro Morais, Baptista Rui
MTG Research and Development Lab, 4200-604 Porto, Portugal.
Center for Health Technology and Services Research-CINTESIS@RISE, MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
J Clin Med. 2024 Aug 31;13(17):5173. doi: 10.3390/jcm13175173.
: A comprehensive and up-to-date review on cardiovascular disease (CVD) risk in patients with COPD is needed. Therefore, we aimed to systematically review the risk of a range of CVD in patients with COPD. : We searched three databases (Pubmed, Web of Science, SCOPUS) from inception to September 2023 using terms related to COPD and CVD. Observational studies were included if they (1) were conducted in adults with a diagnosis of COPD based on the GOLD criteria, spirometry, physician diagnosis, or review of electronic health records; (2) reported the risk of CVD, namely of myocardial infarction (MI), ischaemic heart disease (IHD), atrial fibrillation (AF), heart failure, cerebrovascular disease, pulmonary hypertension, and peripheral vascular disease, compared with a control population using a measure of risk. A narrative synthesis was used. : Twenty-four studies from 2015 to 2023, mainly from Europe ( = 17), were included. A total of 3,485,392 patients with COPD (43.5-76.0% male; 63.9-73.5 yrs) and 31,480,333 (40.0-55.4% male, 49.3-70.0 yrs) controls were included. A higher risk of CVD in patients with COPD was evident regarding overall CVD, MI, IHD, heart failure, and angina. Higher risks of arrhythmia and AF, stroke, sudden cardiac death/arrest, pulmonary embolism, pulmonary hypertension, and peripheral vascular disease were also found, although based on a small amount of evidence. : Patients with COPD have a higher risk of CVD than the general population or matched controls. This review underscores the need for vigilant and close monitoring of cardiovascular risk in individuals with COPD to inform more precise preventive strategies and targeted interventions to enhance their overall management.
需要对慢性阻塞性肺疾病（COPD）患者的心血管疾病（CVD）风险进行全面且最新的综述。因此，我们旨在系统地综述COPD患者发生一系列CVD的风险。我们使用与COPD和CVD相关的术语，检索了三个数据库（PubMed、科学网、Scopus），检索时间从建库至2023年9月。纳入的观察性研究需满足以下条件：（1）研究对象为根据慢性阻塞性肺疾病全球倡议（GOLD）标准、肺功能测定、医生诊断或电子健康记录回顾确诊为COPD的成年人；（2）报告了与对照人群相比，使用风险衡量指标得出的CVD风险，即心肌梗死（MI）、缺血性心脏病（IHD）、心房颤动（AF）、心力衰竭、脑血管疾病、肺动脉高压和外周血管疾病的风险。采用叙述性综合分析。纳入了2015年至2023年的24项研究，主要来自欧洲（n = 17）。共纳入3485392例COPD患者（男性占43.5 - 76.0%；年龄63.9 - 73.5岁）和31480333例对照（男性占40.0 - 55.4%，年龄49.3 - 70.0岁）。在总体CVD、MI、IHD、心力衰竭和心绞痛方面，COPD患者发生CVD的风险更高。虽然证据有限，但也发现心律失常和AF、中风、心源性猝死/心脏骤停、肺栓塞、肺动脉高压和外周血管疾病的风险更高。COPD患者发生CVD的风险高于一般人群或匹配的对照。本综述强调需要对COPD患者的心血管风险进行警惕且密切的监测，以便制定更精确的预防策略和针对性干预措施，加强对他们的整体管理。
