Ann Rheum Dis:类风湿性关节炎对冠心病和非冠心病患者主要心血管事件的影响

2020-06-08 xiangting MedSci原创

在接受CAG的患者中,无论是否存在CAD,RA均与MI、MACE和全因死亡率的10年风险显著相关。

类风湿性关节炎(RA)是血管疾病的危险因素。同时存在RA和冠心病(CAD)的临床结局尚不清楚。

这项研究旨在评估RA对CAD或非CAD患者不良血管事件风险的影响。

这是一项基于人群的队列研究,纳入2003年至2016年接受冠脉血管造影(CAG),并在西丹麦心脏注册中登记的患者,根据是否存在RA和CAD对患者进行分层。终点是心肌梗塞(MI)、主要不良心血管事件(MACE;MI、缺血性卒中和心源性死亡)和全因死亡率。

共纳入125331例患者(RA:n=1732)。中位随访时间5.2年。将既没有RA也没有CAD的患者作为参考(累积MI发病率2.7%),只有RA的患者(3.8%;调整发病率比(IRRadj)1.63,95%CI 1.04-2.54)和只有CAD的患者(9.9%;IRRadj 3.35,95%CI 3.10-3.62)10年MI风险升高,而同时有RA和CAD的患者风险最高(12.2%;IRRadj 4.53,95%CI 3.66-5.59)。对MACE和全因死亡率也观察到相似的关联。

在接受CAG的患者中,无论是否存在CAD,RA均与MI、MACE和全因死亡率的10年风险显著相关。但是,同时有RA和CAD的患者风险最高,对于没有CAD的患者RA的附加风险很小。在RA患者中,通过是否存在CAD进行风险分层有助于筛选和定制治疗策略

原始出处:

Brian Bridal Løgstrup. Impact of rheumatoid arthritis on major cardiovascular events in patients with and without coronary artery disease. Ann Rheum Dis. 29 May 2020.

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JACC:阿托伐他汀可减少跨血管区域的首次和随后的血管不良事件

在SPARCL临床试验中,阿托伐他汀可减少近期中风或短暂性脑缺血发作且无已知冠心病患者的首次中风和首次复合血管事件的发生。这项事后分析的目的是评估SPARCL中所有(第一次和随后的)血管事件的发生率以

Heart:孤独、社会孤立与心血管事件之间的纵向联系

该研究的结果为孤独与心血管事件之间的关系提供了有力的证据。在研究和预防心血管疾病的干预措施中,应将孤独视为心血管疾病的社会心理危险因素。