哮喘与患冠心病的风险：相关队列研究的META分析
2017/11/20
摘要
背景：关于哮喘患者冠心病(CHD)的发病率相关性研究的报道很少，目前尚无定论。
目的：通过Meta分析来判断哮喘患者的冠心病发病率是否有所增加。
方法：通过系统性的查找PubMed and Embase数据库中自2016年8月开始的相关研究，对相关文献和综述进行筛选以确定符合条件的研究。我们的Meta分析中只纳入纵向队列研究。
结果：我们检索到7个研究纳入495024位患者，把不同组数据综合在一起分析发现哮喘患者的冠心病发病率高于对照组（风险比[HR], 1.42; 95%可信区间[CI], 1.30-1.57; P < .001），且研究没有显著的异质性(I2 = 26%, P = 0.19)。女性患者中这种流行病学上的相关性显著高于男性患者（女性: HR, 1.50; 95% CI, 1.41-1.59;男性: HR, 1.31; 95% CI, 1.16-1.47; P = .046）。此外，亚组分析和敏感性分析均证实哮喘与患冠心病的正相关性。
结论：哮喘患者患冠心病的风险升高，尤其在女性人群中。当临床医生遇到哮喘患者的时候应该认识到其中的联系。需要进一步的实践来研究如何在日常实践中管理这种过度的风险。
Asthma and risk of coronary heart disease: A meta-analysis of cohort studies.
Liu H, Fu Y, Wang K.
Abstract
BACKGROUND:Few studies have investigated the incidence of coronary heart disease (CHD) in patients with asthma, and their results remain inconclusive.
OBJECTIVE:To conduct a meta-analysis to determine whether asthma increases the risk of CHD.
METHODS:A systematic literature search of the PubMed and Embase databases from inception to August 2016, complemented with references screening of relevant articles and reviews, was performed to identify eligible studies. Only longitudinal cohort studies were included in our meta-analysis.
RESULTS:The retrieval process yielded 7 studies (12 asthma cohorts) with 495,024 patients. Data pooling across the cohorts revealed that asthma was associated with an increased risk of CHD (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.30-1.57; P < .001), without significant heterogeneity across the studies (I2 = 26%, P = .19). This epidemiologic association was more pronounced in female than in male patients (female: HR, 1.50; 95% CI, 1.41-1.59; male: HR, 1.31; 95% CI, 1.16-1.47; P for interaction = .046). In addition, subgroup and sensitivity analyses supported the positive correlation between asthma and incident CHD.
CONCLUSION:Asthma is related to an increased incidence of CHD, particularly in women. Clinicians should be aware of this association when faced with a patient with asthma. Further investigations are required to examine how this excess risk should be managed in routine practice.
背景：关于哮喘患者冠心病(CHD)的发病率相关性研究的报道很少，目前尚无定论。
目的：通过Meta分析来判断哮喘患者的冠心病发病率是否有所增加。
方法：通过系统性的查找PubMed and Embase数据库中自2016年8月开始的相关研究，对相关文献和综述进行筛选以确定符合条件的研究。我们的Meta分析中只纳入纵向队列研究。
结果：我们检索到7个研究纳入495024位患者，把不同组数据综合在一起分析发现哮喘患者的冠心病发病率高于对照组（风险比[HR], 1.42; 95%可信区间[CI], 1.30-1.57; P < .001），且研究没有显著的异质性(I2 = 26%, P = 0.19)。女性患者中这种流行病学上的相关性显著高于男性患者（女性: HR, 1.50; 95% CI, 1.41-1.59;男性: HR, 1.31; 95% CI, 1.16-1.47; P = .046）。此外，亚组分析和敏感性分析均证实哮喘与患冠心病的正相关性。
结论：哮喘患者患冠心病的风险升高，尤其在女性人群中。当临床医生遇到哮喘患者的时候应该认识到其中的联系。需要进一步的实践来研究如何在日常实践中管理这种过度的风险。
（复旦大学附属中山医院呼吸内科 包晨 摘译 杨冬 审校）
（Ann Allergy Asthma Immunol. 2017;118(6):689-695.）
（Ann Allergy Asthma Immunol. 2017;118(6):689-695.）
Asthma and risk of coronary heart disease: A meta-analysis of cohort studies.
Liu H, Fu Y, Wang K.
Abstract
BACKGROUND:Few studies have investigated the incidence of coronary heart disease (CHD) in patients with asthma, and their results remain inconclusive.
OBJECTIVE:To conduct a meta-analysis to determine whether asthma increases the risk of CHD.
METHODS:A systematic literature search of the PubMed and Embase databases from inception to August 2016, complemented with references screening of relevant articles and reviews, was performed to identify eligible studies. Only longitudinal cohort studies were included in our meta-analysis.
RESULTS:The retrieval process yielded 7 studies (12 asthma cohorts) with 495,024 patients. Data pooling across the cohorts revealed that asthma was associated with an increased risk of CHD (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.30-1.57; P < .001), without significant heterogeneity across the studies (I2 = 26%, P = .19). This epidemiologic association was more pronounced in female than in male patients (female: HR, 1.50; 95% CI, 1.41-1.59; male: HR, 1.31; 95% CI, 1.16-1.47; P for interaction = .046). In addition, subgroup and sensitivity analyses supported the positive correlation between asthma and incident CHD.
CONCLUSION:Asthma is related to an increased incidence of CHD, particularly in women. Clinicians should be aware of this association when faced with a patient with asthma. Further investigations are required to examine how this excess risk should be managed in routine practice.
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哮喘的频繁或罕见发作的比较特征：回顾性和前瞻性事件的纵向研究
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环境空气污染，交通噪音和成人哮喘的患病率:一个BioSHaRE研究
