SYSTEMATIC REVIEW article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1653435
This article is part of the Research TopicComplex Interplay Between Lung Diseases and Multisystem Disorders: Pathogenesis, management, and OutcomeView all 6 articles
Cardiovascular Disease in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis of Observational Studies
Provisionally accepted
- 1Beijing University of Chinese Medicine, Beijing, China
- 2Beijing University of Chinese Medicine Dongfang Hospital, Beijing, China
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Background: Cardiovascular (CV) comorbidities can affect drug tolerability and health outcomes in patients with idiopathic pulmonary fibrosis (IPF). This systematic review and meta-analysis aimed to quantify the magnitudes of association between IPF and both overall and specific categories of CV disease. Methods: The PRISMA guidelines and PICO model were followed. We searched PubMed, Embase, Web of Science, Cochrane Library, and Chinese Biomedical Literature Service System (Sinomed) from inception to April 2025 for studies investigating CV disease in IPF patients. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled odds ratio (OR) for case-control/cross-sectional datasets and relative risk (RR) for cohort datasets were calculated using Review Manager 5.4. The I2 test was used to evaluate the heterogeneity and the sources of heterogeneity were explored through sensitivity analyses, meta-regression, and subgroup analyses. The funnel plot and Egger's test were used to evaluate publication bias. Results: 28 studies comprising 29 case-control/cross-sectional datasets and 4 cohort datasets were included, which indicated a positive association between IPF and CV disease (OR 2.44, 95% CI 1.84–3.24, P<0.001; RR 1.44, 95% CI 1.07-1.92, P=0.02). Meta-regression and maximized subgroup analyses confirmed the influence of control characteristics (P<0.001), data source (P=0.027), Newcastle-Ottawa Scale (NOS) score (P=0.022), certainty of CV disease diagnosis (P=0.027), body mass index (BMI), smoking status, and diabetes prevalence on both heterogeneity and risk estimates in the case-control/cross-sectional datasets. The OR varied across the CV disease category, with This is a provisional file, not the final typeset article 1.14-to 2.51-fold increased risks for ischemic heart disease, thromboembolic disease, pulmonary hypertension, and other forms of heart disease. Conclusions: IPF is significantly associated with CV disease, emphasizing the urgent need for systematic screening and risk reduction strategies in IPF patients.
Keywords: Idiopathic Pulmonary Fibrosis, cardiovascular disease, Ischemic Heart Disease, Thromboembolic disease, pulmonary hypertension, Meta-analysis
Received: 25 Jun 2025; Accepted: 04 Sep 2025.
Copyright: © 2025 Li, Tan, Zhang, Cao, Wu, Jiao and Niu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yang Jiao, Beijing University of Chinese Medicine Dongfang Hospital, Beijing, China
Jie Niu, Beijing University of Chinese Medicine Dongfang Hospital, Beijing, China
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