风湿性关节炎中心房动风险增加:在血清阳性患者中比血清阴性患者更大
Seonyoung Kang1, Yeonghee Eun2, Kyungdo Han3
1Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Heart rhythm
|August 9, 2025
概括
风湿性关节炎 (RA) 患者,无论是血清阳性 (SPRA) 还是血清阴性 (SNRA),都面临着显著增加的心房动 (AF) 风险. 血清阳性RA患者患有AF的风险最高.
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) 和心房动 (AF) 之间的关联需要进一步研究.
- RA 是一种具有已知的心血管影响的自身免疫性疾病.
研究的目的:
- 在全国范围的队列中调查RA和事件AF之间的关联.
- 根据RA血清状况分析AF风险的差异 (血清阳性RA[SPRA]与血清阴性RA[SNRA]).
- 探索生物或向合成疾病修饰性抗风湿药物 (b/tsDMARDs) 对AF风险的影响.
主要方法:
- 使用国家医疗保险服务数据库进行回顾性队列研究.
- 包括在2010-2017年间诊断的RA患者,与年龄和性别的非RA对照 (1:3比) 相匹配.
- 从指数日期后的一年到2020年12月31日进行跟踪,以尽量减少监测偏差.
主要成果:
- 分析了48885名RA患者和146655名对照组的队列.
- 关节炎患者表现出明显更高的AF风险 (aHR 1.55).
- 与对照组相比,SPRA (aHR1.63) 和SNRA (aHR1.37) 均显示AF风险增加,SPRA具有最高风险 (aHR1.19与SNRA).
结论:
- 与没有RA的个人相比,SPRA和SNRA都显著提高了发展AF的风险.
- 在RA患者中,SPRA为AF提供了最高的风险.
- b/tsDMARDs显示了生物药物增加AF风险和向合成药物降低风险的趋势,尽管在统计学上并不显著.
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