Cardiovascular disease in connective tissue disease-associated interstitial lung disease: A systematic review and meta-analysis of observational studies

IF 9.2 1区医学 Q1 IMMUNOLOGY

Autoimmunity reviews Pub Date : 2024-10-01 DOI:10.1016/j.autrev.2024.103614

Ziyi Hu , Haolan Wang , Jinyu Huang , Guanhui Yang , Wenxuan Luo , Jiaxun Zhong , Xiaoli Zheng , Xin Wei , Xiongyan Luo , Anji Xiong

{"title":"Cardiovascular disease in connective tissue disease-associated interstitial lung disease: A systematic review and meta-analysis of observational studies","authors":"Ziyi Hu , Haolan Wang , Jinyu Huang , Guanhui Yang , Wenxuan Luo , Jiaxun Zhong , Xiaoli Zheng , Xin Wei , Xiongyan Luo , Anji Xiong","doi":"10.1016/j.autrev.2024.103614","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> = 0.001) and the proportion of smokers (<em>P</em> = 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"23 10","pages":"Article 103614"},"PeriodicalIF":9.2000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Autoimmunity reviews","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1568997224001058","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.

查看原文本刊更多论文

结缔组织病相关间质性肺病的心血管疾病：观察性研究的系统回顾和荟萃分析。

研究目的我们进行了一项系统综述和荟萃分析，以评估结缔组织病（CTD）相关间质性肺病（ILD）患者是否会增加心血管疾病（CV）的患病率，并验证相关风险因素：方法：研究遵循 PRISMA 指南和 PICO 模型。我们检索了从开始到 2024 年 4 月的 PubMed、Embase、Cochrane Library 数据库、Scopus 和开放获取期刊目录：共纳入13项研究，涉及12520名患者。CTD-ILD患者罹患冠心病的风险明显高于CTD患者（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 患者发生心力衰竭（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。另一项亚组分析显示，RA-ILD 和 SSc-ILD 与心血管疾病风险增加有关，但与 IIM-ILD 和 MCTD-ILD 无关（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 患者的肺动脉高压发病率更高（RR = 2.48，95 % CI：1.69, 3.63）：CTD-ILD患者的心血管疾病风险比CTD-非ILD患者高1.65倍，其中心力衰竭和心律失常的发病率更高。SSc-ILD和RA-ILD患者罹患心血管疾病的风险增加，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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Autoimmunity reviews 医学-免疫学

CiteScore

24.70

自引率

4.40%

发文量

164

审稿时长

21 days

期刊介绍： Autoimmunity Reviews is a publication that features up-to-date, structured reviews on various topics in the field of autoimmunity. These reviews are written by renowned experts and include demonstrative illustrations and tables. Each article will have a clear "take-home" message for readers. The selection of articles is primarily done by the Editors-in-Chief, based on recommendations from the international Editorial Board. The topics covered in the articles span all areas of autoimmunology, aiming to bridge the gap between basic and clinical sciences. In terms of content, the contributions in basic sciences delve into the pathophysiology and mechanisms of autoimmune disorders, as well as genomics and proteomics. On the other hand, clinical contributions focus on diseases related to autoimmunity, novel therapies, and clinical associations. Autoimmunity Reviews is internationally recognized, and its articles are indexed and abstracted in prestigious databases such as PubMed/Medline, Science Citation Index Expanded, Biosciences Information Services, and Chemical Abstracts.