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Do women with endometriosis have higher cardiovascular risk? A systematic review and meta-analyses
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Orientador(es)
Resumo(s)
Objetivo: O risco cardiovascular em mulheres com endometriose (EM) é subestimado. O objetivo deste estudo é realizar uma revisão sistemática de todos os estudos que avaliem a ocorrência de eventos cardiovasculares em pacientes com endometriose em comparação com grupos de controlo.
Métodos: Os estudos potencialmente elegíveis foram identificados através de uma pesquisa eletrónica em bases de dados desde o início da elaboração do trabalho até novembro de 2021 (MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL) e EMBASE). Dois elementos participantes no trabalho reviram os títulos e resumos encontrados. Os resultados avaliados foram cardiopatia isquémica, acidente vascular cerebral e mortalidade cardiovascular. A meta-análise de efeitos aleatórios foi realizada pela ponderação através do método de variância inversa para estimar o risco relativo da ocorrência do evento em função do tempo e intervalos de confiança de 95% (IC 95%), independentemente da heterogeneidade estatística avaliada pela estatística I2. O protocolo do estudo foi registado em PROSPERO: CRD42022298830.
Resultados: Foram incluídos cinco estudos do tipo coorte. A EM foi associada a um risco significativamente maior de cardiopatia isquémica (HR 1,50, IC 95% 1,37, 1,65; I2 = 0%) e de doença cerebrovascular (HR 1,17, IC 95% 1,07, 1,29; I2 = 0%).
Conclusões: A literatura disponível mostra um maior risco de eventos cardiovasculares em mulheres com endometriose.
Background: Cardiovascular risk of women with endometriosis (EM) is underestimated. The aim of this study is to perform a systematic review of all studies that assess the occurrence of cardiovascular events in patients with endometriosis compared to control groups. Methods: Potentially eligible studies were identified through an electronic database search from inception to November 2021 (MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE). Two reviewers screened the titles and abstracts. The evaluated outcomes were ischemic heart disease, stroke and cardiovascular mortality. Random-effects meta-analysis was performed by weighting by the inverse-variance method to estimate pooled hazard ratios and 95% confidence intervals (95% CIs), irrespectively of the statistical heterogeneity assessed through the I2 statistic. The study protocol was registered at PROSPERO: CRD42022298830. Results: Five cohort studies were included. EM was associated with a significantly increased risk of ischemic heart disease (HR 1,50, IC 95% 1,37, 1,65; I2 = 0%) and cerebrovascular disease (HR 1.17, 95% CI 1.07, 1.29; I2 = 0%). Conclusions: The available evidence showed a higher risk of cardiovascular events.
Background: Cardiovascular risk of women with endometriosis (EM) is underestimated. The aim of this study is to perform a systematic review of all studies that assess the occurrence of cardiovascular events in patients with endometriosis compared to control groups. Methods: Potentially eligible studies were identified through an electronic database search from inception to November 2021 (MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE). Two reviewers screened the titles and abstracts. The evaluated outcomes were ischemic heart disease, stroke and cardiovascular mortality. Random-effects meta-analysis was performed by weighting by the inverse-variance method to estimate pooled hazard ratios and 95% confidence intervals (95% CIs), irrespectively of the statistical heterogeneity assessed through the I2 statistic. The study protocol was registered at PROSPERO: CRD42022298830. Results: Five cohort studies were included. EM was associated with a significantly increased risk of ischemic heart disease (HR 1,50, IC 95% 1,37, 1,65; I2 = 0%) and cerebrovascular disease (HR 1.17, 95% CI 1.07, 1.29; I2 = 0%). Conclusions: The available evidence showed a higher risk of cardiovascular events.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Endometriosis Cardiovascular disease Ischemic heart disease Cerebrovascular disease Cardiology