Non-malignant gynaecological disease and risk of cardiovascular or cerebrovascular disease: a systematic review and meta-analysis.

IF 5.1 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Heart Pub Date : 2025-04-10 DOI:10.1136/heartjnl-2024-324675
Giorgia Elisabeth Colombo, Yahya Mahamat-Saleh, Mike Armour, Kedar Madan, Angelo Sabag, Marina Kvaskoff, Stacey A Missmer, George Condous, Faraz Pathan, Mathew Leonardi
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Abstract

Background: Cardiovascular disease is the leading cause of death globally. Non-malignant gynaecological diseases (NMGD) significantly affect patient health and well-being and may be associated with cardiovascular or cerebrovascular disease (C/CVD).

Methods: Seven databases were searched for relevant studies up to 21 April 2024. Observational studies reporting risk estimates and 95% CIs for the association between NMGD and C/CVD were included. Data were extracted by two independent reviewers. Random effects models were used to calculate summary relative risk (SRR) with 95% CI. Composite C/CVD outcome was defined as a combination of ischaemic heart disease, cerebrovascular disease, heart failure, and peripheral vascular disease. The ROBINS-I tool defined study quality and risk of bias.

Results: We screened 6639 studies, of which 59 were eligible for full-text review and 28 were included in our analysis, comprising a total of 3 271 242 individuals. The majority (53.5%) of the studies were scored as having a 'serious'/'critical' risk of bias. Overall, individuals with an NMGD had a significantly greater risk of composite C/CVD with low heterogeneity among contributing studies (SRR 1.28, 95% CI 1.20 to 1.37; n=16 studies, I2=65.3%), ischaemic heart disease (SRR 1.41, 95% CI 1.31 to 1.51; n=21 studies, I2=73.7%), and cerebrovascular disease (SRR 1.33, 95% CI 1.18 to 1.51; n=16 studies, I2=91.5%). In NMGD-specific analyses, the risk of C/CVD and its components was greater among those with a history of endometriosis or polycystic ovary syndrome.

Conclusions: We found an overall association between NMGD and C/CVD across all studies. However, estimates from individual studies varied substantially.

非恶性妇科疾病和心脑血管疾病的风险:一项系统综述和荟萃分析
背景:心血管疾病是全球死亡的主要原因。非恶性妇科疾病严重影响患者的健康和福祉,并可能与心脑血管疾病(C/CVD)有关。方法:检索截至2024年4月21日的7个数据库的相关研究。观察性研究报告了NMGD与C/CVD之间的风险估计和95% ci。数据由两名独立审稿人提取。随机效应模型用于计算总相对风险(SRR), 95% CI。复合C/CVD结局被定义为缺血性心脏病、脑血管疾病、心力衰竭和周围血管疾病的组合。ROBINS-I工具定义了研究质量和偏倚风险。结果:我们筛选了6639项研究,其中59项符合全文综述的条件,28项纳入我们的分析,共计3 271 242人。大多数(53.5%)的研究被评为具有“严重”/“严重”偏倚风险。总体而言,在相关研究中,NMGD患者发生复合C/CVD的风险显著更高,且异质性较低(SRR 1.28, 95% CI 1.20 ~ 1.37;n=16项研究,I2=65.3%),缺血性心脏病(SRR 1.41, 95% CI 1.31 ~ 1.51;n=21项研究,I2=73.7%)和脑血管疾病(SRR 1.33, 95% CI 1.18 ~ 1.51;n=16项研究,I2=91.5%)。在nmgd特异性分析中,有子宫内膜异位症或多囊卵巢综合征病史的患者患C/CVD及其组成部分的风险更高。结论:在所有研究中,我们发现NMGD与C/CVD之间存在总体关联。然而,来自个别研究的估计差异很大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Heart
Heart 医学-心血管系统
CiteScore
10.30
自引率
5.30%
发文量
320
审稿时长
3-6 weeks
期刊介绍: Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.
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