Arthritis Rheumatol:银屑病关节炎和银屑病患者心脏生物标志物与心血管结局的关联

2022-03-12 MedSci原创 MedSci原创

在银屑病患者中,cTnI可能反映了动脉粥样硬化的负担,与传统的心血管危险因素无关。cTnI和NT-proBNP与独立于FRS的心血管事件相关,然而,有必要进一步研究它们在心血管风险分层中的作用。

与普通人群相比,银屑病患者的特点是心血管发病率和死亡率过高。虽然这种过度风险部分是由传统心血管风险因素的高患病率所介导,但慢性全身炎症会促进动脉粥样硬化形成,从而使银屑病患者易患心血管事件的风险增加。

近日,风湿免疫学领域权威杂志Arthritis & Rheumatology上发表了一篇研究文章,在银屑病患者中,研究人员旨在确定心肌肌钙蛋白I(cTnI)和脑型利钠肽前体N末端(NT-proBNP)是否与颈动脉斑块负荷和心血管事件的发生相关,而且独立于弗雷明汉风险评分(FRS)。

在1000名银屑病患者中,研究人员在基线时测量了358名参与者的颈动脉总斑块面积,并使用自动化临床实验对cTnI和NT-proBNP进行了检测。在调整心血管危险因素后,通过多变量回归评估心脏生物标志物与颈动脉粥样硬化之间的关联。研究人员使用风险区分和重新分类的指标评估了对超出FRS的心血管事件预测的改进水平。

在单变量分析中,cTnI(β系数0.52[95%CI为0.3,0.74],p<0.001)和NT-proBNP(β系数0.24[95%CI为0.1,0.39],p<0.001)与颈动脉总斑块面积相关。在调整心血管风险因素后,cTnI的相关性仍然具有统计学意义(调整后的β系数0.21[95%CI为0,0.41],p=0.047),但对NT-proBNP则不然(p=0.21)。在评估心血管风险预测的1000名银屑病患者中,64名患者发生了心血管事件。将基础模型(仅使用FRS)与扩展模型(使用FRS加心脏生物标志物)进行比较时,预测性能没有改善。

由此可见,在银屑病患者中,cTnI可能反映了动脉粥样硬化的负担,与传统的心血管危险因素无关。cTnI和NT-proBNP与独立于FRS的心血管事件相关,然而,有必要进一步研究它们在心血管风险分层中的作用。

原始出处:

Keith Colaço.et al.Association of Cardiac Biomarkers with Cardiovascular Outcomes in Patients with Psoriatic Arthritis and Psoriasis: A Longitudinal Cohort Study.Arthritis Rheumatol.2022.https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.42079

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    2022-03-13 lmm397
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    2022-03-13 zhaojie88
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