論文No1221
Association of Sarcoidosis With Increased Risk of VTE:
A Population-Based Study, 1976 to 2013
Patompong Ungprasert, MD; Cynthia S. Crowson, MS; Eric L. Matteson, MD, MPH
Chest. 2017;151(2):425-430. doi:10.1016/j.chest.2016.09.009
＜背景＞
この研究の目的はサルコイドーシス患者における静脈血栓塞栓(VTE)のリスクを調べることである。
＜方法＞
1976年から2013年のミネソタ州オルムステッド郡における345名のサルコイドーシス患者コホートと性別、年齢をあわせた対象患者345名を包括的医療記録リンクシステムで調べた。
医療記録から深部静脈血栓(DVT)、肺塞栓(PE)を評価した。
累積発生率を評価し、死亡率で補正した。
Cox比例ハザードモデルを使用してサルコイドーシス患者と非サルコイドーシス患者とでVTE, PEの発生を比較した。
＜結果＞
VTE, DVT, PEの頻度はサルコイドーシス患者とコントロール群で有意な差はなかった。
年齢、性別、暦年で補正したVTEの発生率はサルコイドーシス患者の方が有意に高かった (hazard ratio [HR], 3.04 [95% CI, 1.47-6.29])。
DVT(HR, 3.14 (95% CI, 1.32-7.48))でもPE(HR, 4.29 (95% CI, 1.21-15.23))でもリスクが高かった。
参照日付よりも少なくとも6か月後に起こった感度解析ではVTEのみハザード比が若干低かった（ VTE, 2.73 (95% CI, 1.30-5.72); DVT, 3.00 (95% CI, 1.25-7.20); and PE, 3.58 (95% CI, 0.98-13.03)）。
＜感想＞
サルコイドーシス患者では、補正するとVTEのリスクが約３倍高かったようです。
Objective The goal of this study was to investigate the risk of VTE among patients with sarcoidosis.
Methods A cohort of 345 incident cases of sarcoidosis and 345 sex- and age-matched comparator subjects in Olmsted County, Minnesota, from 1976 to 2013 were identified from the comprehensive medical record linkage system. Medical records were reviewed for DVT and pulmonary embolism (PE). The cumulative incidence was estimated, adjusted for the competing risk of death. Cox proportional hazards models were used to compare the rate of development of these events between patients with sarcoidosis and the nonsarcoidosis comparison cohort.
Results The prevalence of VTE, DVT, and PE prior to the index date was not significantly different between case and comparator subjects. The risk of incident VTE adjusted for age, sex, and calendar year was significantly higher among patients with sarcoidosis (hazard ratio [HR], 3.04 [95% CI, 1.47-6.29]). Significantly elevated risk was observed in both subtypes of VTE, with an HR of 3.14 (95% CI, 1.32-7.48) for DVT and an HR of 4.29 (95% CI, 1.21-15.23) for PE. A sensitivity analysis including only VTE events that occurred at least 6 months after the index date adjusted for age, sex, and calendar year revealed somewhat lower HRs: VTE, 2.73 (95% CI, 1.30-5.72); DVT, 3.00 (95% CI, 1.25-7.20); and PE, 3.58 (95% CI, 0.98-13.03).
Conclusions An increased risk of VTE among patients with sarcoidosis was observed in this population-based cohort.