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首页> 外文期刊>Clinical Epidemiology >Rheumatoid Arthritis as a Risk Factor for Coronary Artery Calcification and Obstructive Coronary Artery Disease in Patients with Chest Pain: A Registry Based Cross-Sectional Study
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Rheumatoid Arthritis as a Risk Factor for Coronary Artery Calcification and Obstructive Coronary Artery Disease in Patients with Chest Pain: A Registry Based Cross-Sectional Study

机译：类风湿性关节炎作为胸痛患者冠状动脉钙化和阻塞性冠状动脉疾病的危险因素：基于注册表的横截面研究

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Purpose: To examine the occurrence and severity of coronary artery disease (CAD) in patients with rheumatoid arthritis (RA) compared to non-RA patients in a population referred for coronary computed tomography angiography (CTA) due to chest pain. Patients and Methods: In this cross-sectional study, 46,210 patients from a national CTA database were included. Patients with RA were stratified on serology, treatment with conventional synthetic or biological disease-modifying antirheumatic drugs (DMARDs), and the need for relapse or flare treatment with intraarticular or -muscular glucocorticoid injections (GCIs). Primary outcomes were coronary artery calcium score (CACS) 0 and CACS ≥ 400, and secondary outcome was obstructive CAD. Associations between RA and outcomes were examined using logistic regression and results were adjusted for age, sex, cardiovascular risk factors and comorbidities. Results: A total of 395 (0.9%) RA patients were identified. In overall RA, crude odds ratio (OR) for having CACS 0 was 1.48 (1.21– 1.82) and 1.52 (1.15– 2.01) for CACS ≥ 400, whereas adjusted ORs were 1.08 (0.86– 1.36) and 1.21 (0.89– 1.65), respectively. Seropositive RA patients had adjusted OR of 1.16 (0.89– 1.50) for CACS 0 and 1.37 (0.98– 1.90) for CACS ≥ 400. Patients who had received ≥ 1 GCI in the period of 3 years prior to the CTA had an adjusted OR of 1.37 (0.94– 2.00) for having CACS 0 and 1.46 (0.92– 2.31) for CACS ≥ 400. Conclusion: This is the first large-scale, CTA-based study examining the occurrence and severity of CAD in RA patients with symptoms suggestive of cardiovascular disease. A higher prevalence of coronary artery calcification was found in RA patients. After adjusting for age, sex, cardiovascular risk factors and comorbidities, the tendency was less pronounced. We found a trend for increased coronary calcification in RA patients being seropositive or needing treatment with GCI for a relapse or flare.
机译：目的：与由于胸部疼痛的冠状动脉计算断层造影血管造影（CTA）的非Ra患者相比，患者类风湿性关节炎（RA）患者冠状动脉疾病（CAD）的发生和严重程度。患者和方法：在这个横断面研究中，包括来自国家CTA数据库的46,210名患者。 RA患者在血清学上分层，用常规的合成或生物疾病改性抗耳肿类药物（DMARDS）治疗，以及用细胞内或 - 啮齿性糖皮质激素注射（GCIS）进行复发或闪光处理。主要结果是冠状动脉钙评分（CAC）> 0和CAC≥400，二次结果是阻塞性的CAD。使用Logistic回归检查RA和结果之间的关联，结果调整了年龄，性别，心血管危险因素和合并症。结果：鉴定了总共395（0.9％）患者。在整体RA中，CAC≥400的具有CACS> 0的粗次数比（或）为1.48（1.21- 1.82）和1.52（1.15-2.01），而调整或0.08（0.86-1.36）和1.21（0.89-1.65 ）， 分别。 CACS≥400的CACS> 0和1.37（0.98- 1.90）调节或1.16（0.89-1.50）调节或1.16（0.98- 1.90）。在CTA之前3年内收到≥1GCI的患者进行了调整后或CACS≥400的CACS> 0和1.46（0.92-2.31）的1.37（0.94- 2.00）。结论：这是第一种大规模，基于CTA的研究，检查RA患者中CAD的发生和严重程度暗示心血管疾病。在RA患者中发现了冠状动脉钙化的更高患病率。调整年龄，性别，心血管危险因素和合并症后，趋势不太明显。我们发现RA患者中冠状动脉钙化增加的趋势是血清阳性或用GCI治疗进行复发或耀斑。

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