Jiménez-Gómez Miguel, de-Torres-Tajes Juan Pablo
Pulmonology Department, 12th of October University Hospital, Madrid, Spain.
Pulmonology Department, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
Open Respir Arch. 2024 Sep 4;6(4):100357. doi: 10.1016/j.opresp.2024.100357. eCollection 2024 Oct-Dec.
Literature suggests that there is a close relationship between chronic obstructive pulmonary disease (COPD) and cardiovascular (CV) disease. The aim of this study was to assess whether the presence of coronary calcium (CC) on chest computed tomography (CT) in asymptomatic COPD patients is associated with an increased risk of CV events and mortality.
A systematic review of the literature was performed following PRISMA recommendations. Studies published in the last 20 years in four databases (PubMed, Web of Science, Embase and MEDLINE) were included.
Three hundred fifty articles were identified, eight of them met the selection criteria. The included studies, conducted between 2013 and 2024, were predominantly multicentre cohort studies. The meta-analysis showed that the presence of CC on chest CT of COPD patients is an independent predictor of CV events (hazard ratio 1.44, 95% CI 1.22-1.70) and associated with an increased mortality during the follow-up period (hazard ratio 1.57, 95% CI 1.35-1.83).
Our analysis suggests that the identification of CC on chest CT scans of COPD patients may be useful in the early detection and treatment of CV disease in asymptomatic patients. Prospective, multicentre studies confirming our findings are needed to explore the potential impact of early detection and treatment of CV risk in COPD patients.
文献表明,慢性阻塞性肺疾病(COPD)与心血管(CV)疾病之间存在密切关系。本研究的目的是评估无症状COPD患者胸部计算机断层扫描(CT)上冠状动脉钙化(CC)的存在是否与心血管事件风险增加和死亡率相关。
按照PRISMA建议对文献进行系统综述。纳入过去20年在四个数据库(PubMed、科学网、Embase和MEDLINE)发表的研究。
共识别出350篇文章,其中8篇符合入选标准。纳入的研究在2013年至2024年期间进行,主要是多中心队列研究。荟萃分析表明,COPD患者胸部CT上CC的存在是心血管事件的独立预测因素(风险比1.44,95%置信区间1.22 - 1.70),并与随访期间死亡率增加相关(风险比1.57,95%置信区间1.35 - 1.83)。
我们的分析表明,在COPD患者胸部CT扫描中识别CC可能有助于无症状患者心血管疾病的早期检测和治疗。需要进行前瞻性、多中心研究来证实我们的发现,以探索COPD患者心血管风险早期检测和治疗的潜在影响。