在开始生物治疗的类风湿性关节炎患者中新开发的心血管风险因素
Wojciech Zaręba1, Piotr Krawiec2,3, Małgorzata Banaszkiewicz4
1Department of Cardiology, Jozef Dietl Specialist Hospital, Krakow, Poland.
Reumatologia
|February 7, 2024
概括
开始服用生物药物的类风湿性关节炎患者需要对心血管风险因素进行查,特别是老年人. 识别一个风险因素也可能表明长期前景较差.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 临床医学 临床医学
背景情况:
- 风湿性关节炎 (RA) 是心血管疾病 (CV) 的重要危险因素,是RA患者死亡的主要原因.
- 生物疗法越来越多地用于RA管理,需要了解相关的心血管风险.
研究的目的:
- 在接受生物治疗的类风湿性关节炎患者中调查新的心血管风险因素的发生率.
- 确定新的心血管风险因素的预测因素及其与主要心脏不良事件 (MACE) 的关联.
主要方法:
- 353名RA患者的回顾性评估,这些患者患有高度的疾病活性,开始生物治疗 (2001-2018).
- 根据基线CV状态,患者被分为两类:明显的CVD,至少有一个CV风险因素 (atCVrisk) 或没有CV风险因素 (vlCVrisk).
- 分析了至少6个月的随访数据,以确定发生的心血管风险因素和MACE.
主要成果:
- 在41.9个月的中位随访期间,25.2%的患者出现了新的心血管风险因素,最常见的是脂质障碍和高血压.
- 在有CV风险 (4.2%) 和明显的心血管疾病 (18.2%) 组中观察到事件MACE,但在vCV风险组中没有.
- 年龄是发生心血管风险因素的重要预测因素. 在年龄调整后的分析中,基线体重指数 (BMI) 是一个独立的预测因素.
结论:
- 开始服用生物药物的RA患者需要对心脏代谢风险因素进行查,重点是老年人.
- 任何基线心血管风险因素的存在可能与未来心血管不良事件的风险增加有关.
- 早期识别和管理心血管风险因素对于改善RA患者的长期预后至关重要.
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