An increased risk of pulmonary hypertension in patients with combined pulmonary fibrosis and emphysema: a meta-analysis.
COPD
CPFE
IPF
Meta-analysis
PH
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
21 Jun 2023
21 Jun 2023
Historique:
received:
01
12
2022
accepted:
07
04
2023
medline:
23
6
2023
pubmed:
22
6
2023
entrez:
21
6
2023
Statut:
epublish
Résumé
Pulmonary hypertension (PH) is a common complication of combined pulmonary fibrosis and emphysema (CPFE). Whether the incidence of PH is increased in CPFE compared with pure pulmonary fibrosis or emphysema remains unclear. This meta-analysis aimed to evaluate the risk of PH in patients with CPFE compared to those with IPF or COPD/emphysema. We searched the PubMed, Embase, Cochrane Library, and CNKI databases for relevant studies focusing on the incidence of PH in patients with CPFE and IPF or emphysema. Pooled odds ratios (ORs) and standard mean differences (SMD) with 95% confidence intervals (95% CIs) were used to evaluate the differences in the clinical characteristics presence and severity of PH between patients with CPFE, IPF, or emphysema. The survival impact of PH in patients with CPFE was assessed using hazard ratios (HRs). A total of 13 eligible studies were included in the meta-analysis, involving 560, 720, and 316 patients with CPFE, IPF, and emphysema, respectively. Patients with CPFE had an increased PH risk with a higher frequency of pulmonary hypertension and higher estimated systolic pulmonary artery pressure (esPAP), compared with those with IPF (OR: 2.66; 95% CI: 1.55-4.57; P < 0.01; SMD: 0.86; 95% CI: 0.52-1.19; P < 0.01) or emphysema (OR: 3.19; 95% CI: 1.42-7.14; P < 0.01; SMD: 0.73; 95% CI: 0.50-0.96; P < 0.01). In addition, the patients with CPFE combined with PH had a poor prognosis than patients with CPFE without PH (HR: 6.16; 95% CI: 2.53-15.03; P < 0.01). Our meta-analysis showed that patients with CPFE were associated with a significantly higher risk of PH compared with those with IPF or emphysema alone. The presence of PH was a poor predictor of mortality.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Pulmonary hypertension (PH) is a common complication of combined pulmonary fibrosis and emphysema (CPFE). Whether the incidence of PH is increased in CPFE compared with pure pulmonary fibrosis or emphysema remains unclear. This meta-analysis aimed to evaluate the risk of PH in patients with CPFE compared to those with IPF or COPD/emphysema.
METHODS
METHODS
We searched the PubMed, Embase, Cochrane Library, and CNKI databases for relevant studies focusing on the incidence of PH in patients with CPFE and IPF or emphysema. Pooled odds ratios (ORs) and standard mean differences (SMD) with 95% confidence intervals (95% CIs) were used to evaluate the differences in the clinical characteristics presence and severity of PH between patients with CPFE, IPF, or emphysema. The survival impact of PH in patients with CPFE was assessed using hazard ratios (HRs).
RESULTS
RESULTS
A total of 13 eligible studies were included in the meta-analysis, involving 560, 720, and 316 patients with CPFE, IPF, and emphysema, respectively. Patients with CPFE had an increased PH risk with a higher frequency of pulmonary hypertension and higher estimated systolic pulmonary artery pressure (esPAP), compared with those with IPF (OR: 2.66; 95% CI: 1.55-4.57; P < 0.01; SMD: 0.86; 95% CI: 0.52-1.19; P < 0.01) or emphysema (OR: 3.19; 95% CI: 1.42-7.14; P < 0.01; SMD: 0.73; 95% CI: 0.50-0.96; P < 0.01). In addition, the patients with CPFE combined with PH had a poor prognosis than patients with CPFE without PH (HR: 6.16; 95% CI: 2.53-15.03; P < 0.01).
CONCLUSIONS
CONCLUSIONS
Our meta-analysis showed that patients with CPFE were associated with a significantly higher risk of PH compared with those with IPF or emphysema alone. The presence of PH was a poor predictor of mortality.
Identifiants
pubmed: 37344866
doi: 10.1186/s12890-023-02425-4
pii: 10.1186/s12890-023-02425-4
pmc: PMC10283193
doi:
Types de publication
Meta-Analysis
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
221Informations de copyright
© 2023. The Author(s).
Références
Respirology. 2014 Feb;19(2):239-245
pubmed: 25198924
BMC Pulm Med. 2013 May 22;13:31
pubmed: 23697753
Am J Respir Crit Care Med. 2002 Aug 1;166(3):314-22
pubmed: 12153963
BMC Pulm Med. 2016 Nov 3;16(1):137
pubmed: 27809901
Circ J. 2013;77(9):2383-9
pubmed: 23759655
J Am Coll Cardiol. 2013 Dec 24;62(25 Suppl):D109-16
pubmed: 24355635
Eur Respir J. 2020 Jan 30;55(1):
pubmed: 31649067
Respirol Case Rep. 2013 Sep;1(1):10-3
pubmed: 25473528
Chest. 2013 Jul;144(1):234-240
pubmed: 23370641
Chest. 2009 Jul;136(1):10-15
pubmed: 19225068
Sarcoidosis Vasc Diffuse Lung Dis. 2021;38(3):e2021024
pubmed: 34744420
J Xray Sci Technol. 2022;30(1):185-193
pubmed: 34864713
Arterioscler Thromb Vasc Biol. 2019 Nov;39(11):2303-2319
pubmed: 31510791
J Chin Med Assoc. 2019 Dec;82(12):922-928
pubmed: 31800533
Int J Tuberc Lung Dis. 2011 Aug;15(8):1111-6
pubmed: 21740677
Eur J Epidemiol. 2010 Sep;25(9):603-5
pubmed: 20652370
Respir Res. 2020 Jun 30;21(1):164
pubmed: 32605574
Eur Respir J. 2005 Oct;26(4):586-93
pubmed: 16204587
Respir Med Case Rep. 2019 Sep 27;28:100940
pubmed: 31667076
BMJ Open Respir Res. 2016 Feb 22;3(1):e000099
pubmed: 26933506
Lung. 2014 Aug;192(4):553-61
pubmed: 24818955
Chest. 2021 Nov;160(5):1743-1750
pubmed: 34186034
Intern Med. 2016;55(12):1529-35
pubmed: 27301501
ERJ Open Res. 2019 Mar 18;5(1):
pubmed: 30895186
Respiration. 2016;92(4):220-228
pubmed: 27576553
Eur Respir J. 2010 Jan;35(1):105-11
pubmed: 19643948
J Thorac Dis. 2015 Apr;7(4):767-79
pubmed: 25973246
Dis Model Mech. 2019 May 15;12(5):
pubmed: 31036697
Respiration. 2008;76(3):288-94
pubmed: 18216461
ERJ Open Res. 2022 May 16;8(2):
pubmed: 35586449
ERJ Open Res. 2022 Jan 24;8(1):
pubmed: 35083317
Am J Respir Crit Care Med. 2022 Aug 15;206(4):e7-e41
pubmed: 35969190
Eur Respir J. 2023 Jan 6;61(1):
pubmed: 36028254
Can Assoc Radiol J. 2010 Dec;61(5):291-6
pubmed: 20382500
Ann Am Thorac Soc. 2020 Oct;17(10):1333-1336
pubmed: 32610025
Chest. 2020 Aug;158(2):722-734
pubmed: 32184109
Eur Respir J. 2013 Jun;41(6):1292-301
pubmed: 23018917
Eur Respir J. 2015 Nov;46(5):1370-7
pubmed: 26250495
Heart Lung. 2012 Sep-Oct;41(5):512-7
pubmed: 22054725
Respir Med. 2009 Aug;103(8):1136-42
pubmed: 19403296
Clin Exp Rheumatol. 2014 Nov-Dec;32(6 Suppl 86):S-109-14
pubmed: 25372796
ERJ Open Res. 2020 Dec 14;6(4):
pubmed: 33344625
Eur Respir J. 2011 Jul;38(1):176-83
pubmed: 21148225
Histopathology. 2017 May;70(6):896-905
pubmed: 27992963
BMC Res Notes. 2013;6 Suppl 1:S2
pubmed: 23734851
Chin Med J (Engl). 2014;127(3):469-74
pubmed: 24451952
Adv Med Sci. 2019 Sep;64(2):285-291
pubmed: 30947142
Int J Chron Obstruct Pulmon Dis. 2021 Jun 21;16:1873-1885
pubmed: 34188464