在被诊断患有类风湿性关节炎的妇女中,心血管发病率和死亡率
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
概括
患有类风湿性关节炎的女性面临心肌梗塞的风险增加了一倍. 长期类风湿性关节炎 (RA) 显著增加心脏病发作风险,强调了在RA患者中预防心血管疾病的必要性.
科学领域:
- 类风湿病学 类风湿病学
- 心脏病学 心脏病学
- 流行病学 流行病学
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性炎症性疾病.
- RA 可能与心血管疾病 (CVD) 的风险增加有关.
研究的目的:
- 为了比较心肌梗塞 (MI) 和中风的发病率在RA和没有RA的女性中.
- 调查RA持续时间和心脏病发作风险之间的关联.
主要方法:
- 来自护士健康研究 (1976-2000) 的114,342名女性的前性队列研究.
- 在基线排除具有先前存在心血管疾病或RA的参与者.
- 通过医疗记录审查确认RA,MI和中风病例.
- 多变量逻辑回归调整为心血管疾病风险因素.
主要成果:
- 在RA的妇女中观察到心脏病发作风险增加 (调整后RR=2.0,95%CI:1.23-3.29).
- 患有RA的女性中风风险没有显著增加 (调整后RR=1.48,95%CI:0.70-3.12).
- 患有风湿性关节炎的女性≥10年有显著更高的MI风险 (调整后RR=3.10,95%CI:1.64-5.87).
结论:
- 风湿性关节炎与显著更高的心脏病发作风险有关,但并不是中风.
- 研究结果表明,需要在RA患者中加强冠状动脉心脏病预防策略.
- 需要进一步的研究来证实这些关联并指导临床实践.
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