リウマチ性関節炎と診断された女性の心血管疾患と死亡率

Daniel H Solomon¹, Elizabeth W Karlson, Eric B Rimm

¹Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA. dhsolomon@partners.org

Circulation

|March 12, 2003

まとめ

リウマチ性関節炎を患っている女性は,心筋梗塞のリスクが2倍に増加します. 長期的なリウマチ性関節炎 (RA) は心臓発作のリスクを大幅に高め,RA患者の心血管疾患予防の必要性を強調しています.

科学分野:

レウマトロジーの病理学
心臓病学心臓病学
エピデミオロジーエピデミオロジー

背景:

リウマチ性関節炎 (RA) は慢性炎症性疾患である.
RAは,心血管疾患 (CVD) のリスクの増加と潜在的に関連しています.

研究の目的:

発症率を比較する発症率を比較する発症率を比較する発症率を比較する発症率を比較する
RAの持続時間とMIのリスクとの関連を調査する.

主な方法:

看護師の健康研究 (1976-2000) の女性114,342人を対象とした前向きなコホート研究.
予行CVDまたはRAを有する参加者の排除.
RA,MI,および脳卒中症例の確認は,医療記録のレビューを通じて行われます.
CVDリスク因子に調整された多変数ロジスティック回帰.

主要な成果:

RAの女性では,心筋梗塞のリスク増加が観察されました (調整RR=2.0,95%CI: 1.23-3.29).
RAの女性では脳卒中のリスクが有意に増加しなかった (調整RR=1.48,95%CI:0.70-3.12).
10年以上RAを患っていた女性は,かなり高いMIリスク (調整RR=3.10,95%CI:1.64-5.87) を有していた.

結論:

RAは心筋梗塞のリスクが著しく高まっているが,脳卒中のリスクは高くない.
研究結果は,RA患者における冠動脈疾患予防戦略の強化の必要性を示唆しています.
これらの関連性を確認し,臨床実践を導くために,さらなる研究が必要である.

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