Vitiligo is associated with an increased risk of cardiovascular diseases: a large-scale, propensity-matched, US-based retrospective study.

IF 9.7 1区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

EBioMedicine Pub Date : 2024-11-01 Epub Date: 2024-10-25 DOI:10.1016/j.ebiom.2024.105423

Alicja Frączek, Agnieszka Owczarczyk-Saczonek, Ralf J Ludwig, Gema Hernandez, Sascha Ständer, Diamant Thaci, Henner Zirpel

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引用次数: 0

Abstract

Background: Vitiligo is an autoimmune disease, characterized by specific destruction of melanocytes. While associations with numerous comorbid conditions, which potentially increase the risk of cardiovascular diseases have been described, data on the risk for cardiovascular disease is inconclusive. To address this relevant knowledge gap, this study aims to identify the risk of cardiovascular disease in vitiligo.

Methods: The US Collaborative Network was accessed using the TriNetX platform, allowing retrospective data retrieval from electronic health records (EHRs) from 57 US based health care organizations (HCOs). Patients with vitiligo and controls were identified by their respective ICD10 codes. Risk of onset of several cardiovascular diseases was determined in patients within 15 years after diagnoses.

Findings: A total of 94 diagnoses with a prevalence of ≥1% in both cohorts, which consisted of 96,581 individuals per group after propensity-score-matching, were identified. Of those, 54 displayed an increased risk in vitiligo. None of the cardiovascular diseases investigated were associated with a decreased risk in patients with vitiligo. Specifically, cerebral infarction occurred in 1.3% of patients with vitiligo, and 1.0% in controls. This difference translated into a hazard ratio (HR) of 1.21 (95% confidence interval [CI] 1.11-1.32, p_adj < 0.001). Venous thromboembolism was recorded in 1.34% of cases and 1.02% of controls without vitiligo, resulting in an increased HR of 1.27 (95% CI 1.171-1.38, p_adj < 0.001). Further, major adverse cardiovascular events (MACE) as a composite endpoint was evaluated. The risk for MACE was increased following a vitiligo diagnosis (HR 1.28, 95% CI 1.22-1.35, p_adj < 0.001), which persisted in both sensitivity analyses.

Interpretation: Patients with vitiligo display an increased risk of onset of cardiovascular diseases as compared to healthy individuals. Thus, vitiligo might require more precise monitoring and systemic treatment.

Funding: This research was supported by the Schleswig-Holstein Excellence-Chair Program from the State of Schleswig Holstein, by the Excellence Cluster Precision Medicine in Chronic Inflammation (DFG, EXC 2167), and by DFG Individual Grant LU 877/25-1.

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白癜风与心血管疾病风险增加有关：一项基于美国的大规模倾向匹配回顾性研究。

背景介绍白癜风是一种自身免疫性疾病，其特点是黑色素细胞遭到特异性破坏。虽然已经描述了白癜风与许多合并症的关系，这些合并症可能会增加心血管疾病的风险，但有关心血管疾病风险的数据尚无定论。为了填补这一相关知识空白，本研究旨在确定白癜风患者罹患心血管疾病的风险：方法：使用 TriNetX 平台访问美国协作网络，从美国 57 家医疗机构的电子健康记录 (EHR) 中进行回顾性数据检索。通过各自的 ICD10 编码确定了白癜风患者和对照组。在确诊后的 15 年内，确定了患者罹患多种心血管疾病的风险：结果：经过倾向分数匹配后，共确定了 94 项诊断，这些诊断在两个队列中的患病率均≥1%，每个队列中有 96,581 人。其中，54种疾病显示白癜风的发病风险增加。在所调查的心血管疾病中，没有一种疾病与白癜风患者患病风险降低有关。具体来说，1.3%的白癜风患者会发生脑梗塞，而对照组的脑梗塞发生率为1.0%。这一差异导致危险比（HR）为 1.21（95% 置信区间 [CI] 1.11-1.32，padj adj adj）：与健康人相比，白癜风患者罹患心血管疾病的风险更高。因此，白癜风可能需要更精确的监测和系统治疗：本研究得到了石勒苏益格-荷尔斯泰因州 "石勒苏益格-荷尔斯泰因州卓越主席计划"（Schleswig-Holstein Excellence-Chair Program）、"慢性炎症中的卓越精准医学"（DFG, EXC 2167）以及DFG个人基金LU 877/25-1的资助。

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来源期刊

EBioMedicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology

CiteScore

17.70

自引率

0.90%

发文量

579

审稿时长

5 weeks

期刊介绍： eBioMedicine is a comprehensive biomedical research journal that covers a wide range of studies that are relevant to human health. Our focus is on original research that explores the fundamental factors influencing human health and disease, including the discovery of new therapeutic targets and treatments, the identification of biomarkers and diagnostic tools, and the investigation and modification of disease pathways and mechanisms. We welcome studies from any biomedical discipline that contribute to our understanding of disease and aim to improve human health.