参与心血管查咨询,谁,何时,为什么 - 一项针对类风湿性关节炎患者的队列研究
Julie Katrine Karstensen1,2,3, Ann Bremander4,5,6,7, Jeanette Reffstrup Christensen8,9,10
1Department of Regional Health Research, University of Southern Denmark, Odense, Denmark. jkarstensen@danskgigthospital.dk.
BMC rheumatology
|February 21, 2024
概括
大多数类风湿性关节炎患者参加初始心血管风险查. 然而,只有一半的高风险患者参加后续查,这表明需要了解坚持障碍.
科学领域:
- 类风湿病学 类风湿病学
- 心血管医学 心血管医学
- 公共卫生 公共卫生
背景情况:
- 建议对类风湿性关节炎 (RA) 患者进行系统心血管 (CV) 风险评估.
- 自2011年以来,丹麦医院已向RA患者提供心血管风险评估,并邀请高风险患者进行随访.
- 了解参与和坚持对于优化RA中CV风险管理至关重要.
研究的目的:
- 探索参与RA患者系统的CV风险评估.
- 为了确定低CV风险和高CV风险RA患者之间的差异.
- 调查与高风险RA患者遵守随访查相关的因素.
主要方法:
- 从2,222名RA门诊患者 (2011-2021) 获取数据,重点关注1,522名75岁以下的符合条件的患者.
- 使用修改后的系统冠状动脉风险评估 (mSCORE) 来评估10年心血管死亡风险.
- 采用后勤回归,威尔科克森等级和奇平方测试来分析风险因素和坚持.
主要成果:
- 大多数符合条件的RA患者 (1,149/1,522) 接受了初始心血管查;91人拒绝了.
- 高风险患者表现出更长的疾病持续时间,更高的甘油三,HbA1c,疼痛和HAQ分数.
- 高风险患者更有可能减少随访 (43%对28%);那些随访减少的人年龄较大,疾病持续时间较短.
结论:
- 最初的CV查被RA患者接受得很好.
- 对后续查的坚持是不理想的,只有高风险患者的一半参加了查.
- 疾病影响和生活方式因素没有预测坚持;需要进一步研究患者的动机.
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