Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.
Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2024 Sep 20;14(1):21928. doi: 10.1038/s41598-024-72549-y.
Parkinson's disease (PD) reports high rates of morbidity and mortality, but the risk of adverse cardiovascular outcomes in patients with PD has not been fully elucidated. This bi-center retrospective cohort study using the electronic health records (EHR) database of two tertiary hospitals screened a total of 327,292 subjects who visited the outpatient clinic, and 1194 patients with PD were propensity score-matched with a control population. The primary outcome was the occurrence of major adverse cardiovascular events (MACE). Key secondary outcomes included all-cause death, cardiovascular (CV) death, stroke, myocardial infarction (MI), heart failure hospitalization and 30-day CV death. After PS matching, MACE occurrence was not significantly different between PD and non-PD groups (18.2% vs. 17.5%, log-rank p = 0.98). Key secondary outcomes were also similar between the two groups. In patients with PD, MACE rate, and also CV risk score, were higher in patients with more severe PD (according to Hoehn and Yahr scale and unified Parkinson's disease rating scale), and after multivariable analysis, PD severity was not an independent predictor of MACE. Patients with PD are at an increased risk of adverse cardiovascular outcomes, but the contribution from other common CV risk factors cannot be ignored. The management of prevalent CV risk factors is therefore important in mitigating adverse outcomes among patients with PD.
帕金森病（PD）报告的发病率和死亡率较高，但 PD 患者发生不良心血管结局的风险尚未完全阐明。本研究使用两家三级医院的电子健康记录（EHR）数据库进行了一项回顾性队列研究，共筛选了 327292 名门诊就诊患者，其中 1194 名 PD 患者与对照组进行了倾向评分匹配。主要结局是主要不良心血管事件（MACE）的发生。关键次要结局包括全因死亡、心血管（CV）死亡、中风、心肌梗死（MI）、心力衰竭住院和 30 天 CV 死亡。PS 匹配后，PD 组和非 PD 组的 MACE 发生率无显著差异（18.2% vs. 17.5%，log-rank p=0.98）。两组关键次要结局也相似。在 PD 患者中，MACE 发生率以及 CV 风险评分在 Hoehn 和 Yahr 量表和统一帕金森病评定量表评分较高的患者中更高，多变量分析后，PD 严重程度不是 MACE 的独立预测因素。PD 患者发生不良心血管结局的风险增加，但不能忽视其他常见 CV 危险因素的作用。因此，管理常见的 CV 危险因素对于减轻 PD 患者的不良结局很重要。
