Background Idiopathic pulmonary fibrosis (IPF) is a relatively rare disease with increasing incidence trends. Cardiovascular disease is a significant complication in IPF patients due to the role of common proatherogenic immune mediators. The prevalence of coronary artery disease (CAD) in IPF and the association between these distinct pathologies with overlapping pathophysiology remain less studied. Research question We hypothesised that IPF is an independent risk factor for CAD. Methods We conducted a retrospective case–control study using the national inpatient sample (2017–2019). We included adult hospitalisations with IPF after excluding other interstitial lung diseases and other endpoints of CAD, acute coronary syndrome and old myocardial infarction. We examined their baseline characteristics, such as demographic data, hospital characteristics and socioeconomic status. The prevalence of cardiac risk factors and CAD was also compared between hospitalisations with and without IPF. Univariate and multivariate regression analysis was further performed to study the odds of CAD with IPF. The cases of IPF in the study population were propensity-matched, after which generalised linear modelling analysis was performed to validate the findings. Results A total of 116 010 admissions were hospitalised in 2017–2019 with IPF, of which 55.6% were men with a mean age of 73 years. Adult hospitalisations with IPF were found to have a higher prevalence of diabetes mellitus (29.3% vs 24.0%; p<0.001), hypertension (35.6% vs 33.8%; p<0.001), hyperlipidaemia (47.7% vs 30.2%; p<0.0001) and tobacco abuse (41.7% vs 20.9%; p<0.001), while they had a lower prevalence of obesity (11.7% vs 15.3%; p<0.0001) compared with hospitalisations without IPF. Multivariate logistic regression analysis revealed 28% higher odds of developing CAD in IPF hospitalisations (OR −1.28; CI 1.22 to 1.33; p<0.001). Postpropensity matching, generalised linear modelling analysis revealed even higher odds of CAD with IPF (OR −1.77; CI 1.54 to 2.02; p<0.001) Conclusions Our study found a higher prevalence of CAD in IPF hospitalisations and significantly higher odds of CAD among IPF cases. IPF remains a terminal lung disease that portends a poor prognosis, but addressing the cardiovascular risk factors in these patients can help reduce the case fatality rate due to the latter and potentially add to quality-adjusted life years. Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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了解冠状动脉疾病的一步：特发性肺纤维化的并发症

背景 特发性肺纤维化（IPF）是一种相对罕见的疾病，且发病率呈上升趋势。由于常见的促动脉粥样硬化免疫介质的作用，心血管疾病是 IPF 患者的一个重要并发症。 IPF 中冠状动脉疾病 (CAD) 的患病率以及这些不同病理学与重叠病理生理学之间的关联仍较少研究。研究问题 我们假设 IPF 是 CAD 的独立危险因素。方法 我们利用全国住院患者样本（2017-2019 年）进行了回顾性病例对照研究。在排除其他间质性肺疾病以及 CAD、急性冠状动脉综合征和陈旧性心肌梗死的其他终点后，我们纳入了因 IPF 住院的成人患者。我们检查了他们的基线特征，例如人口数据、医院特征和社会经济状况。还比较了有和没有 IPF 住院期间心脏危险因素和 CAD 的患病率。进一步进行单变量和多变量回归分析来研究 CAD 合并 IPF 的几率。对研究人群中的 IPF 病例进行倾向匹配，然后进行广义线性模型分析以验证研究结果。结果 2017-2019 年，共有 116 010 例 IPF 住院患者，其中 55.6% 为男性，平均年龄 73 岁。因 IPF 住院的成人，糖尿病（29.3% vs 24.0%；p<0.001）、高血压（35.6% vs 33.8%；p<0.001）、高脂血症（47.7% vs 30.2%；p<0.0001）患病率较高）和吸烟（41.7% vs 20.9%；p<0.001），而与无 IPF 住院相比，他们的肥胖患病率较低（11.7% vs 15.3%；p<0.0001）。多变量逻辑回归分析显示，IPF 住院期间发生 CAD 的几率高出 28%（OR -1.28；CI 1.22 至 1.33；p<0.001）。后倾向匹配、广义线性模型分析显示 CAD 合并 IPF 的几率更高（OR -1.77；CI 1.54 至 2.02；p<0.001） 结论 我们的研究发现 IPF 住院中 CAD 的患病率较高，并且 IPF 病例中 CAD 的几率显着更高。 IPF 仍然是一种晚期肺部疾病，预示着预后不良，但解决这些患者的心血管危险因素可以帮助降低后者引起的病死率，并有可能延长质量调整生命年。数据可在公共、开放访问存储库中获取。与研究相关的所有数据都包含在文章中或作为补充信息上传。