JACC:系统性红斑狼疮患者的长期心血管结局风险和预后

2021-04-18 Nebula MedSci原创

系统性红斑狼疮患者的多种心血管结局的长期风险较高且预后不良~

系统性红斑狼疮(SLE)是一种多发于青年女性的累及多脏器的自身免疫性炎症性结缔组织病,早期、轻型和不典型的病例日渐增多。SLE可累及患者的血管,但目前SLE患者的长期心血管预后数据很少。

本研究旨在研究系统性红斑狼疮患者的长期心血管结局的风险和预后,包括心力衰竭(HF)。

研究人员采用丹麦行政登记处的数据,比较了1996年至2018年确诊的SLE患者(无心血管疾病病史)与背景人群中年龄、性别和共发病均匹配的对照组受试者(匹配比例为1:4)的预后风险。此外,研究人员还比较了发生心力衰竭的SLE患者和年龄/性别相匹配的非SLE对照患者确诊HF后的死亡率(匹配比例为1:4)。

总体上,共纳入了3411名SLE患者(中位年龄:44.6岁;14.1%的男性)与13644名匹配的对照受试者。

两组患者的长期预后

中位随访时间为8.5年。SLE患者的多种心血管结局的10年预后绝对风险明显高于对照组,分别为(SLE患者 vs 对照受试者):心力衰竭:3.71%(95%[CI 3.02%-4.51%) vs 1.94%(1.68%~2.24%),心房颤动:4.35%(3.61%-5.18%) vs 2.82%(2.50%-3.16%),缺血性卒中:3.75%(3.06%-4.54%) vs 1.92%(1.66%-2.20%),心肌梗死:2.17%(1.66%-2.80%) vs 1.49%(1.26%-1.75%),静脉血栓栓塞率:6.03%(5.17%-6.98%) vs 1.68%(1.44%-1.95%),植入性心律失常/心脏骤停:0.89%(0.58%-1.31%) vs 0.30%(0.20%-0.43%)。

与无系统性红斑狼疮的心衰患者相比,继发心衰的系统性红斑狼疮患者的死亡率更高(调整后的危险比 1.50;95%CI 1.08-2.08)。

总而言之,与匹配的对照组相比,SLE患者发生心力衰竭和其他心血管结局的相关风险更高。而且,在发生心衰的患者中,有系统性红斑狼疮病史的患者的死亡率相比无SLE病史的患者更高。

原始出处:

Yafasova Adelina,Fosbol Emil L,Schou Morten et al. Long-Term Cardiovascular Outcomes in Systemic Lupus Erythematosus. J Am Coll Cardiol, 2021, 77: 1717-1727.

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    2022-05-24 ms2000001047183780

    请教各位老师SLE合并急性心肌梗死伴LAD血栓形成如何治疗?

    0

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    2021-12-06 hbwxf
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    2021-04-20 zhouqu_8
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    2021-04-19 ZJYYY7

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    2021-04-19 ZJYYY7

    sle发生心衰机率更高

    0

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