风湿性关节炎中的大动脉狭窄风险
Tate M Johnson1,2, Chetaj A Mahabir3, Yangyuna Yang2
1Medicine & Research Service, VA Nebraska-Western Iowa Health Care System, Omaha.
JAMA internal medicine
|July 31, 2023
概括
类风湿性关节炎 (RA) 显著增加患上大动脉狭窄症 (AS) 的风险,导致大动脉干预和AS相关死亡的可能性更高. 这突出了AS作为RA患者的潜在并发症.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 流行病学 流行病学
背景情况:
- 类风湿性关节炎 (RA) 与缺血性心血管疾病风险增加有关.
- 风湿性关节炎和大动脉狭窄 (AS) 风险之间的关联仍然不清楚.
研究的目的:
- 调查RA患者发生AS的风险.
- 评估RA患者的大动脉干预和与AS相关的死亡风险.
- 在RA的背景下,确定AS发展的风险因素.
主要方法:
- 一项大型队列研究将退伍军人卫生管理局和医疗保险数据 (2000-2019年) 联系起来.
- 患有RA的患者与没有RA的最多10个对照组相匹配.
- 大动脉狭窄是由诊断,门置换或与AS相关的死亡来定义的; 考克斯模型用于风险评估.
主要成果:
- 该研究包括超过73,000名RA患者和超过639,000名对照人群.
- 关节炎患者的AS发病率较高 (3.97对每1000人年2.45).
- RA 与复合AS (AHR,1.48),大动脉干预 (AHR,1.34) 和与AS相关的死亡 (AHR,1.26) 的风险显著增加有关.
结论:
- 类风湿性关节炎与发展大动脉狭窄症的风险大大增加.
- 患有RA的患者面临着对大动脉干预和与AS有关的死亡率的风险增加.
- 大动脉狭窄可能是类风湿性关节炎中未被认可的心血管并发症,需要进一步调查.
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