Clinical Research in Cardiology ( IF 3.8 ) Pub Date : 2021-10-15 , DOI: 10.1007/s00392-021-01945-5 Wen Qi Gan 1 , Jane A. Buxton 1, 2 , Heather Palis 1, 3 , Naveed Z. Janjua 1, 2, 4 , Chloé G. Xavier 1 , Bin Zhao 1 , Amanda K. Slaunwhite 1, 2 , Frank X. Scheuermeyer 5, 6 , Roshni Desai 7
|
Background
North America has been experiencing an unprecedented epidemic of drug overdose. This study investigated the associations of drug overdose with the risk of cardiovascular disease (CVD) and 11 major CVD subtypes.
Methods
This nested case–control study was based on a cohort of 20% random sample of residents in British Columbia, Canada, who were aged 18–80 years and did not have known CVD at baseline (n = 617,863). During a 4-year follow-up period, persons who developed incident CVD were identified as case subjects, and the onset date of CVD was defined as the index date. For each case subject, we used incidence density sampling to randomly select up to five control subjects from the cohort members who were alive and did not have known CVD by the index date, were admitted to an emergency department or hospital on the index date for non-CVD causes, and were matched on age, sex, and region of residence. Overdose exposure on the index date and each of the previous 5 days was examined for each subject.
Results
This study included 16,113 CVD case subjects (mean age 53 years, 59% male) and 66,875 control subjects. After adjusting for covariates, overdose that occurred on the index date was strongly associated with CVD [odds ratio (OR), 2.9; 95% confidence interval (CI), 2.4–3.5], especially for arrhythmia (OR, 8.6; 95% CI, 6.2–12.0), ischemic stroke (OR, 5.3; 95% CI, 2.0–14.1), hemorrhagic stroke (OR, 3.1; 95% CI, 1.2–8.3), and myocardial infarction (OR, 3.0; 95% CI, 1.5–5.8). The CVD risk was decreased but remained significantly elevated for overdose that occurred on the previous day, and was not observed for overdose that occurred on each of the previous 2–5 days.
Conclusions
Drug overdose appears to be associated with increased risk of cardiovascular diseases.
Graphic abstract
中文翻译：
药物过量和心血管疾病风险：嵌套病例对照研究
背景
北美一直在经历前所未有的药物过量流行。这项研究调查了药物过量与心血管疾病 (CVD) 和 11 种主要 CVD 亚型的风险之间的关联。
方法
这项巢式病例对照研究基于加拿大不列颠哥伦比亚省居民的 20% 随机样本队列，这些居民年龄在 18-80 岁之间，基线时没有已知的 CVD ( n = 617,863)。在 4 年的随访期间，将发生 CVD 事件的人确定为病例对象，并将 CVD 的发病日期定义为索引日期。对于每个病例受试者，我们使用发生率密度抽样从队列成员中随机选择最多 5 名对照受试者，这些受试者在索引日期之前还活着并且没有已知 CVD，在索引日期因非-CVD 原因，并且在年龄、性别和居住地区上进行匹配。对每个受试者在索引日期和前 5 天中的每一天检查过量暴露。
结果
该研究包括 16,113 名 CVD 病例受试者（平均年龄 53 岁，59% 为男性）和 66,875 名对照受试者。调整协变量后，指标日期发生的用药过量与 CVD 密切相关 [优势比 (OR)，2.9；95% 置信区间 (CI)，2.4-3.5]，尤其是心律失常 (OR, 8.6; 95% CI, 6.2-12.0)、缺血性卒中 (OR, 5.3; 95% CI, 2.0-14.1)、出血性卒中 (OR) , 3.1; 95% CI, 1.2-8.3) 和心肌梗死 (OR, 3.0; 95% CI, 1.5-5.8)。CVD 风险降低，但前一天发生的药物过量仍显着升高，并且未观察到前 2-5 天发生的药物过量。
结论
药物过量似乎与心血管疾病风险增加有关。
京公网安备 11010802027423号