Background and Aims Endometriosis, a systemic gynaecological disease affecting 10% of women in reproductive age, shares pathophysiological characteristics with cardiovascular disease. However, data on the relationship between endometriosis and cardiovascular outcomes are scarce, prompting this study to address the knowledge gap. Methods Using Danish nationwide registries, women diagnosed with endometriosis (1977–2021) were identified and matched with controls in a 1:4 ratio based on year of birth. The primary outcome was a composite of acute myocardial infarction and ischaemic stroke. The secondary outcomes were arrhythmias, heart failure, and mortality. Results In total, 60 508 women with endometriosis and 242 032 matched controls were included (median age 37.3 years). Women with endometriosis were more comorbid and used more medications than controls. The incidence rates of the composite outcomes were 3.2 [95% confidence interval (CI) 3.2–3.3] and 2.7 (95% CI 2.7–2.8) per 1000 person-years among women with and without endometriosis, respectively. Women with endometriosis had a significantly higher associated rate of the composite outcome compared with controls [unadjusted hazard ratio (HR) 1.18 (95% CI 1.14–1.23), adjusted HR 1.15 (95% CI 1.11–1.20)]. Likewise, women with endometriosis were also at significantly increased associated risk of arrhythmias [unadjusted HR 1.24 (95% CI 1.20–1.28) and adjusted HR 1.21 (95% CI 1.17–1.25)] and heart failure [unadjusted HR 1.16 (95% CI 1.09–1.22) and adjusted HR 1.11 (95% CI 1.05–1.18)] but at decreased risk of mortality [unadjusted HR 0.95 (95% CI 0.92–0.97) and adjusted HR 0.93 (95% CI 0.91–0.96)]. Conclusions Women with endometriosis have a higher associated long-term risk of cardiovascular outcomes compared with controls. Despite subtle absolute risk differences, the high prevalence of endometriosis underscores the importance of these findings.

中文翻译：

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子宫内膜异位症和长期心血管风险：一项丹麦全国性研究


背景和目的子宫内膜异位症是一种影响 10% 育龄妇女的全身性妇科疾病，与心血管疾病具有共同的病理生理特征。然而，关于子宫内膜异位症与心血管结果之间关系的数据很少，促使这项研究解决知识差距。方法 使用丹麦全国登记处，根据出生年份以 1：4 的比例确定被诊断患有子宫内膜异位症 （1977-2021） 的女性并与对照组匹配。主要结局是急性心肌梗死和缺血性卒中的复合结局。次要结局是心律失常、心力衰竭和死亡率。结果 共纳入 60 508 例子宫内膜异位症女性和 242 032 例匹配的对照 （中位年龄 37.3 岁）。与对照组相比，子宫内膜异位症女性的合并症更多，使用的药物更多。在患有和未患有子宫内膜异位症的女性中，复合结局的发生率分别为每 1000 人年 3.2 [95% 置信区间 （CI） 3.2-3.3] 和 2.7 （95% CI 2.7-2.8）。与对照组相比，子宫内膜异位症女性的复合结局相关率显著更高 [未校正风险比 （HR） 1.18 （95% CI 1.14-1.23），校正 HR 1.15 （95% CI 1.11-1.20）]。同样，患有子宫内膜异位症的女性患心律失常 [未校正 HR 1.24 （95% CI 1.20-1.28） 和校正 HR 1.21 （95% CI 1.17-1.25）] 和心力衰竭 [未校正 HR 1.16 （95% CI 1.09-1.22） 和校正 HR 1.11 （95% CI 1.05-1.18）] 的相关风险也显著增加，但死亡风险降低 [校正 HR 0.95 （95% CI 0.92-0.97） 和校正 HR 0.93 （95% CI 0.91-0.96）]。结论 与对照组相比，子宫内膜异位症女性心血管结局的相关长期风险更高。 尽管存在细微的绝对风险差异，但子宫内膜异位症的高患病率强调了这些发现的重要性。