类风湿性关节炎中新发作的劳动残疾是一个未被认可的心血管风险因素:使用CorEvitas注册表的回顾性队列研究
Robert Spandorfer1, Kevin Kane2, Dimitrios A Pappas3
1Hospital for Special Surgery, Division of Rheumatology, New York, NY, USA.
Seminars in arthritis and rheumatism
|November 17, 2024
概括
患有类风湿性关节炎 (RA) 无法工作的患者面临更高的心血管疾病 (CVD) 风险. 在残疾的RA患者中,这种心血管疾病风险增加仍然很大,即使考虑到各种健康和社会经济因素.
科学领域:
- 类风湿病学 类风湿病学
- 心血管医学 心血管医学
- 职业健康 职业健康 职业健康
背景情况:
- 类风湿性关节炎 (RA) 患者的劳动残疾率高于一般人群.
- 了解RA中劳动残疾对健康的影响对于患者管理至关重要.
研究的目的:
- 调查65岁以下的类风湿性关节炎 (RA) 患者新发作劳动残疾和心血管疾病 (CVD) 风险之间的关联.
- 确定导致该人群中心血管疾病风险升高的因素.
主要方法:
- 追溯性队列研究,使用来自CorEvitas RA注册表的数据.
- 纳入标准:65岁以下的RA患者. 暴露:新发作的工作残疾. 进行比较:持续工作的RA患者.
- 年龄和性别匹配的队列;分析包括人口统计学,药物,疾病因素和使用Poisson和Cox回归模型的传统心血管疾病风险因素.
主要成果:
- 与工作组相比,心血管疾病的发病率在新发作劳动残疾组 (5.40/1000人年) 显著高于工作组 (2.17/1000人年).
- 劳动残疾与心血管疾病风险增加2.32倍相关 (HR=2.32).
- 即使对功能状态,教育,药物和传统心血管疾病风险因素进行调整,过度心血管疾病风险仍然显著 (HR=1.78).
结论:
- 年轻的RA患者经历了新发作的劳动残疾,与他们的工作同行相比,他们面临着相当高的发生心血管疾病的风险.
- 无法解释的CVD风险过高表明未测量的因素的影响,可能包括健康和全静态负载的社会决定因素.
更多相关视频
04:50Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
85
07:44Author Spotlight: Implementation of BIVA for Analyzing Disease Risk Factors in Patients with Low Body Cell Mass
Published on: July 14, 2023
1.1K
相关概念视频
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
7
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
7
01:23Rheumatic Heart Disease I: Introduction
3
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
3
01:20Rheumatic Heart Disease IV: Nursing Management
5
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
5
01:21Rheumatic Heart Disease III: Medical Management
3
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
3
01:27Psychoneuroimmunology: Cardiovascular Disease
25
Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
A key area of focus in PNI is the relationship between stress and coronary...
25
01:22Pericarditis I: Introduction
2
Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
2