免疫介导炎症疾病和冠状动脉:基线风险升高和预后梯度减弱
Prerna Singh1, Michael D Glidden2, Santosh Sirasapalli2
1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, 44106, USA.
免疫媒介性炎症性疾病 (IMID) 患者的心血管风险更高,即使冠状动脉 (CAC) 评分为零. 传统的CAC评分对IMID患者的预后价值较低.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 预防医学 预防医学
背景情况:
- 免疫媒介性炎症性疾病 (IMID) 与加速动脉样硬化有关.
- 对CT冠状动脉评分 (CTCS) 反映IMID患者心血管风险过高的准确性尚不清楚.
研究的目的:
- 调查CTCS是否准确地捕获IMID成年人的心血管风险.
- 确定IMID是否会改变冠状动脉 (CAC) 评分和主要心脏不良事件 (MACE) 之间的关系.
主要方法:
- 对来自CLARIFY注册表的43,420名接受CTCS的个人进行分析.
- 545名IMID患者的倾向性得分与1090名非IMID对照进行匹配.
- 考克斯模型和相互作用术语评估了根据IMID状态分层的CAC类别和MACE风险.
主要成果:
- 与对照组相比,IMID患者的MACE发病率是IMID患者的两倍多 (40.8人/年,相比17.6人/1000人/年).
- 即使CAC得分为零,IMID患者的MACE率也增加了三倍.
- 在IMID患者中,增加MACE的CAC得分的预后价值显著减弱.
结论:
- 在IMID患者中,零CAC得分并不能保证低心血管风险.
- 与一般人群相比,冠状动脉评分对IMID患者的渐进性预后价值有所降低.
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