PDF(Pubmed)
Abstract：
UNASSIGNED: Rheumatoid arthritis (RA) is a risk factor (RF) for cardiovascular (CV) disease, a leading cause of mortality in RA patients.
UNASSIGNED: Consecutive records of RA patients with high disease activity screened upon biologic therapy initiation were reviewed between January 2001 and 2018. Patients with at least 6-month follow-up and baseline disease activity scores were enrolled (n = 353) and stratified into manifest CV disorder (\"overt CVD\"), any traditional CV risk factor (\"atCVrisk\") and no CV risk factor (\"vlCVrisk\") groups.
UNASSIGNED: Overall, mean (SD) patient age was 51.4 (±12.2) years, and 291 (82.4%) subjects were female. Median follow-up was 41.9 (IQR 18.6, 80) months. Overall, 89 (25.2%) individuals developed at least one new CV RF, of which 65 (18.4%) acquired one and 24 (6.8%) two or more. Incident lipid disorders (42, 11.9%), followed by hypertension (14, 4%), atrial fibrillation (17, 4.8%) and venous thromboembolism (VTE) (16, 4.5%), were common. Incident major adverse cardiac events (MACE) were not reported in the vlCVrisk group, in contrast to atCVrisk (n = 8, 4.2%) or overt CVD (n = 4, 18.2%). Age was a significant predictor of incident CV risk factor (HR 1.04, 95% CI: 1.02-1.07; p < 0.01). In age-adjusted analyses, only baseline body mass index (BMI) (HR 1.11, 95% CI: 1.04-1.18; p < 0.01), but not ever smoking (p = 0.93), male sex (p = 0.26), positive RF (p = 0.24), positive ACPA (p = 0.90), or baseline disease activity (p = 0.19), were independent predictor of incident CV risk factors.
UNASSIGNED: Patients with RA initiating biologics should be screened for cardiometabolic risk factors, especially at an older age. The presence of at least one risk factor may be linked to a worse long-term prognosis.
UNASSIGNED: Consecutive records of RA patients with high disease activity screened upon biologic therapy initiation were reviewed between January 2001 and 2018. Patients with at least 6-month follow-up and baseline disease activity scores were enrolled (n = 353) and stratified into manifest CV disorder (\"overt CVD\"), any traditional CV risk factor (\"atCVrisk\") and no CV risk factor (\"vlCVrisk\") groups.
UNASSIGNED: Overall, mean (SD) patient age was 51.4 (±12.2) years, and 291 (82.4%) subjects were female. Median follow-up was 41.9 (IQR 18.6, 80) months. Overall, 89 (25.2%) individuals developed at least one new CV RF, of which 65 (18.4%) acquired one and 24 (6.8%) two or more. Incident lipid disorders (42, 11.9%), followed by hypertension (14, 4%), atrial fibrillation (17, 4.8%) and venous thromboembolism (VTE) (16, 4.5%), were common. Incident major adverse cardiac events (MACE) were not reported in the vlCVrisk group, in contrast to atCVrisk (n = 8, 4.2%) or overt CVD (n = 4, 18.2%). Age was a significant predictor of incident CV risk factor (HR 1.04, 95% CI: 1.02-1.07; p < 0.01). In age-adjusted analyses, only baseline body mass index (BMI) (HR 1.11, 95% CI: 1.04-1.18; p < 0.01), but not ever smoking (p = 0.93), male sex (p = 0.26), positive RF (p = 0.24), positive ACPA (p = 0.90), or baseline disease activity (p = 0.19), were independent predictor of incident CV risk factors.
UNASSIGNED: Patients with RA initiating biologics should be screened for cardiometabolic risk factors, especially at an older age. The presence of at least one risk factor may be linked to a worse long-term prognosis.
摘要：
■类风湿性关节炎（RA）是心血管（CV）疾病的危险因素（RF），RA患者死亡的主要原因。
■回顾了2001年1月至2018年1月生物治疗开始后筛查的高疾病活动性RA患者的连续记录。纳入至少6个月随访和基线疾病活动评分的患者（n=353），并分层为明显的CV障碍（“明显的CVD”），任何传统的CV危险因素(“atCVrisk”)和无CV危险因素(“vlCVrisk”)组。
■总的来说，平均（SD）患者年龄为51.4（±12.2）岁，291名(82.4%)受试者为女性。中位随访时间为41.9(IQR18.6,80)个月。总的来说,89人(25.2%)开发了至少一种新的CV射频，其中65人（18.4%）获得1名，24人（6.8%）获得2名或以上。意外血脂紊乱（42，11.9%），其次是高血压（14，4%），心房颤动（17，4.8%）和静脉血栓栓塞（VTE）（16，4.5%），很常见。vlCVrisk组中未报告主要不良心脏事件（MACE）。与CVrisk（n=8，4.2％）或明显的CVD（n=4，18.2％）相反。年龄是心血管事件危险因素的显著预测因子(HR1.04,95%CI:1.02-1.07;p<0.01)。在年龄调整分析中，仅基线体重指数（BMI）（HR1.11，95％CI：1.04-1.18；p<0.01），但从未吸烟（p=0.93），男性（p=0.26），正RF(p=0.24)，正ACPA（p=0.90），或基线疾病活动(p=0.19)，是心血管事件危险因素的独立预测因子。
■RA起始生物制剂患者应进行心脏代谢危险因素筛查，尤其是年龄较大的时候。至少一种危险因素的存在可能与较差的长期预后有关。
■回顾了2001年1月至2018年1月生物治疗开始后筛查的高疾病活动性RA患者的连续记录。纳入至少6个月随访和基线疾病活动评分的患者（n=353），并分层为明显的CV障碍（“明显的CVD”），任何传统的CV危险因素(“atCVrisk”)和无CV危险因素(“vlCVrisk”)组。
■总的来说，平均（SD）患者年龄为51.4（±12.2）岁，291名(82.4%)受试者为女性。中位随访时间为41.9(IQR18.6,80)个月。总的来说,89人(25.2%)开发了至少一种新的CV射频，其中65人（18.4%）获得1名，24人（6.8%）获得2名或以上。意外血脂紊乱（42，11.9%），其次是高血压（14，4%），心房颤动（17，4.8%）和静脉血栓栓塞（VTE）（16，4.5%），很常见。vlCVrisk组中未报告主要不良心脏事件（MACE）。与CVrisk（n=8，4.2％）或明显的CVD（n=4，18.2％）相反。年龄是心血管事件危险因素的显著预测因子(HR1.04,95%CI:1.02-1.07;p<0.01)。在年龄调整分析中，仅基线体重指数（BMI）（HR1.11，95％CI：1.04-1.18；p<0.01），但从未吸烟（p=0.93），男性（p=0.26），正RF(p=0.24)，正ACPA（p=0.90），或基线疾病活动(p=0.19)，是心血管事件危险因素的独立预测因子。
■RA起始生物制剂患者应进行心脏代谢危险因素筛查，尤其是年龄较大的时候。至少一种危险因素的存在可能与较差的长期预后有关。
