Data submission.

Background
Cardiovascular disease (CVD) is a growing concern among people with spinal cord injury (SCI). This meta-analysis aims to explore the risk of overall CVD and specific types of cardiovascular events among SCI patients.
Methods
This meta-analysis is registered on PROSPERO (CRD CRD42024537888). The data sources comprised PubMed, Embase, the Cochrane Library, and reference lists of the included studies. The literature collection span is from database establishment until April 17, 2024. This meta-analysis encompassed observational studies investigating the association between SCI and the risk of overall types of CVD or specific CVD types. Risk of bias was evaluated utilizing the Newcastle-Ottawa Quality Assessment Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) Scale. Odds ratios (ORs) with 95% confidence intervals (CIs) were aggregated using a random-effects model.
Results
Our initial search generated 5357 relevant records form these international databases. This meta-analysis encompassed 9 observational studies involving 2,282,691 individuals, comprising 193,045 patients with SCI and 2,209,646 controls. We observed a 1.56-fold [OR = 1.56, 95% CI (1.43, 1.70), I2 = 91.3%, P < 0.001] rise in the risk of overall types of CVD among SCI patients, with a 1.82-fold increase in males and a 1.76-fold increase in females. SCI patients without comorbidities exhibited a 2.10-fold elevated risk of overall CVD types, while those with comorbidities had a 1.48-fold increased risk. Concerning specific CVD types, SCI patients showed a 1.58-fold [OR = 1.57, 95% CI (1.22, 2.03), I2 = 92.4%] higher risk of myocardial infarction, a 1.52-fold [OR = 1.52, 95% CI (1.07, 2.16), I2 = 88.7%] increase in atrial fibrillation, a 1.64-fold [OR = 1.64, 95% CI (1.22, 2.20), I2 = 95.5%] elevation in heart failure risk, and 2.38-fold [OR = 2.38, 95% CI (1.29, 4.40), I2 = 92.5%] increments in stroke risk. But there was no statistically significant difference in the risk of hypertension [OR = 1.54, 95% CI (0.98, 2.42), I2 = 96.6%].
Conclusions
The risk of overall CVD in SCI patients surpassed that of the non-SCI control group, with elevated risks of specific cardiovascular events like myocardial infarction, atrial fibrillation, heart failure, and stroke. Clinicians should prioritize awareness of CVD risks in SCI patients.

### 背景
心血管疾病（Cardiovascular Disease, CVD）是脊髓损伤（Spinal Cord Injury, SCI）人群日益受到关注的健康问题。本荟萃分析旨在探讨脊髓损伤患者发生总体心血管疾病及各类特异性心血管不良事件的风险。

### 方法
本荟萃分析已在PROSPERO平台注册（注册号：CRD42024537888）。数据来源包括PubMed、Embase、Cochrane图书馆以及纳入研究的参考文献列表。文献检索时限为各数据库建库至2024年4月17日。本分析纳入所有探讨脊髓损伤与总体心血管疾病或特异性心血管疾病亚型风险相关性的观察性研究。采用纽卡斯尔-渥太华质量评价量表（Newcastle-Ottawa Quality Assessment Scale, NOS）及美国医疗保健研究与质量管理署（Agency for Healthcare Research and Quality, AHRQ）量表对研究偏倚风险进行评估。采用随机效应模型合并比值比（Odds Ratios, ORs）及95%置信区间（Confidence Intervals, CIs）。

### 结果
初步检索共从上述国际数据库获取5357条相关记录。本荟萃分析最终纳入9项观察性研究，共计2282691名研究对象，其中脊髓损伤患者193045例，对照人群2209646例。结果显示，脊髓损伤患者总体心血管疾病发病风险升高1.56倍[OR=1.56，95%CI(1.43,1.70)，I²=91.3%，P<0.001]；其中男性患者风险升高1.82倍，女性患者升高1.76倍。无合并症的脊髓损伤患者总体心血管疾病风险升高2.10倍，合并症患者则升高1.48倍。针对特异性心血管疾病亚型，脊髓损伤患者心肌梗死风险升高1.58倍[OR=1.57，95%CI(1.22,2.03)，I²=92.4%]，心房颤动风险升高1.52倍[OR=1.52，95%CI(1.07,2.16)，I²=88.7%]，心力衰竭风险升高1.64倍[OR=1.64，95%CI(1.22,2.20)，I²=95.5%]，脑卒中风险升高2.38倍[OR=2.38，95%CI(1.29,4.40)，I²=92.5%]；但高血压发病风险未观察到统计学显著差异[OR=1.54，95%CI(0.98,2.42)，I²=96.6%]。

### 结论
脊髓损伤患者的总体心血管疾病发病风险显著高于非脊髓损伤对照人群，且心肌梗死、心房颤动、心力衰竭及脑卒中等特异性心血管不良事件风险均有所升高。临床医师应重视脊髓损伤患者的心血管疾病风险防控。