Long-term cardiovascular outcomes among adult survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis: a retrospective cohort study using TriNetX.

IF 3.7 4区 医学 Q1 DERMATOLOGY
Sheng-Hsiang Ma, Cian-Hao Yeh, Tai-Li Chen, Chen-Yi Wu, Chih-Chiang Chen
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Abstract

Background: The long-term sequelae of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are increasingly being recognized. However, few studies have evaluated the long-term risk of cardiovascular diseases in these patients.

Objectives: This study aimed to investigate the long-term cardiovascular outcomes in survivors of SJS/TEN.

Methods: In total, 2738 SJS/TEN survivors and 2738 propensity-score-matched controls were enrolled from the US Collaborative Network in the TriNetX database. The primary outcome of this study was the development of a major cardiovascular event (MACE). Patients were followed up from 3 months after the index date until the first diagnosis of an outcome event, withdrawal from the database, or 5 January 2025.

Results: We found that SJS/TEN survivors had a significantly elevated risk of MACE [hazard ratio (HR) 2.13], ischaemic heart disease (HR 1.57), cerebrovascular disease (HR 2.13) and mortality (HR 1.94) compared with the matched healthy controls. Additionally, the association remained significant in most stratifications, including female, different age groups, disease severity (SJS, SJS/TEN overlap syndrome and TEN) and initial hospitalization status.

Conclusions: Some potential confounders may not be acquired in the database. In addition, detection bias is another potential source of bias in this study. This study revealed that SJS/TEN survivors have a significantly higher long-term risk of developing MACE. Understanding these sequelae may provide insights for the holistic care of SJS/TEN survivors.

Stevens-Johnson综合征和中毒性表皮坏死松解成年幸存者的长期心血管预后:一项使用TriNetX的回顾性队列研究
背景:Stevens-Johnson综合征(SJS)和中毒性表皮坏死松解症(TEN)的长期后遗症越来越被人们所认识。然而,很少有研究评估这些患者患心血管疾病的长期风险。目的:本研究旨在调查SJS/TEN幸存者的长期心血管结局。方法:共有2738名SJS/TEN幸存者和2738名倾向评分匹配的对照者从TriNetX数据库的美国协作网络中入组。本研究的主要结局是主要心血管事件(MACE)的发生。从索引日期后3个月开始对患者进行随访,直到首次诊断出结果事件、从数据库中退出或2025年1月5日。结果:我们发现,与匹配的健康对照组相比,SJS/TEN幸存者发生MACE(危险比2.13)、缺血性心脏病(危险比1.57)、脑血管疾病(危险比2.13)和死亡率(危险比1.94)的风险显著升高。此外,在大多数分层中,相关性仍然显著,包括女性、不同年龄组、疾病严重程度(SJS、SJS/TEN重叠综合征和TEN)和初始住院情况。结论:一些潜在的混杂因素可能无法从数据库中获取。此外,检测偏倚是本研究中另一个潜在的偏倚来源。本研究显示,SJS/TEN幸存者发生MACE的长期风险明显较高。了解这些后遗症可以为SJS/TEN幸存者的整体护理提供见解。
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
CiteScore
3.20
自引率
2.40%
发文量
389
审稿时长
3-8 weeks
期刊介绍: Clinical and Experimental Dermatology (CED) is a unique provider of relevant and educational material for practising clinicians and dermatological researchers. We support continuing professional development (CPD) of dermatology specialists to advance the understanding, management and treatment of skin disease in order to improve patient outcomes.
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