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Endometriosis and cardiovascular disease: a systematic review and meta-analysis

2023Journal article Open access
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dc.contributor.authorPoeta Do Couto, Celina
dc.contributor.authorPoliciano, Catarina
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorBrito, Dulce
dc.contributor.authorCaldeira, Daniel
dc.date.accessioned2023-04-18T11:18:26Z
dc.date.available2023-04-18T11:18:26Z
dc.date.issued2023
dc.description© 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/pt_PT
dc.description.abstractObjectives: Endometriosis is a benign, estrogen-dependent, chronic inflammatory disease and is the commonest cause of chronic pelvic pain in younger women. Cardiovascular disease is the main cause of death worldwide. Because the relationship between endometriosis and CV disease is not well established, we performed a systematic review of longitudinal studies that assessed the occurrence of cardiovascular events in women with endometriosis compared to those without endometriosis. Study design: Systematic review with meta-analysis of longitudinal cohort/nested case-control studies with endometriosis patients and controls. A search was conducted of the MEDLINE, CENTRAL, and Embase databases from inception to November 2022. Random-effects meta-analysis was performed to estimate pooled hazard ratios (HR) and 95 % confidence intervals (95%CI). Main outcome measure: Cardiovascular outcomes such as ischemic heart disease and cerebrovascular disease. Results: Six cohort studies were included, with a total of 254,929 participants. Meta-analysis showed that endometriosis was associated with a significantly increased risk of ischemic heart disease (HR 1.50, 95%CI 1.37–1.65; I 2 = 0 %) and cerebrovascular disease (HR 1.17, 95%CI 1.07–1.29; I 2 = 0 %). The one study that examined the relationship between cardiovascular mortality and endometriosis found a decreased risk in women with endometriosis relative to women without endometriosis (HR 0.55 (95%CI 0.47–0.65)). Conclusions: Endometriosis is associated with a significantly increased risk of cardiovascular disease, namely ischemic heart disease and cerebrovascular disease. Further studies are required to determine if endometriosis and/or its treatments are risk factors (particularly for cardiovascular mortality), and whether preventive measures could reduce the burden of cardiovascular disease in women with endometriosis. Study protocol registered at PROSPERO: CRD42022298830.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMaturitas 171 (2023) 45–52pt_PT
dc.identifier.doi10.1016/j.maturitas.2023.04.001pt_PT
dc.identifier.eissn1873-4111
dc.identifier.issn0378-5122
dc.identifier.urihttp://hdl.handle.net/10451/57171
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/maturitaspt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectEndometriosispt_PT
dc.subjectCardiovascular diseasept_PT
dc.subjectStrokept_PT
dc.subjectMyocardial infarctionpt_PT
dc.subjectSystematic reviewpt_PT
dc.subjectMeta-analysispt_PT
dc.titleEndometriosis and cardiovascular disease: a systematic review and meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage52pt_PT
oaire.citation.startPage45pt_PT
oaire.citation.titleMaturitaspt_PT
oaire.citation.volume171pt_PT
person.familyNamePoeta do Couto
person.familyNamePinto
person.familyNameBrito
person.familyNameCaldeira
person.givenNameCelina
person.givenNameFausto J.
person.givenNameDulce
person.givenNameDaniel
person.identifier1308889
person.identifier.ciencia-idD415-3272-59C6
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.ciencia-idF216-586F-1762
person.identifier.ciencia-idAA19-EC35-8D01
person.identifier.orcid0000-0002-8104-9345
person.identifier.orcid0000-0002-6749-942X
person.identifier.orcid0000-0002-8034-4529
person.identifier.orcid0000-0003-1278-1847
person.identifier.orcid0000-0002-2520-5673
person.identifier.ridG-9363-2015
person.identifier.ridG-9650-2016
person.identifier.scopus-author-id7102740158
person.identifier.scopus-author-id7004510538
person.identifier.scopus-author-id36623384200
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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