Non-invasive assessment of arterial stiffness in patients with rheumatoid arthritis: A systematic review and meta-analysis of literature studies
Non-invasive assessment of arterial stiffness in patients with rheumatoid arthritis: A systematic review and meta-analysis of literature studies
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DOI：
10.3109/07853890.2015.1068950
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发表时间：
2015-01-01
影响因子：
4.4
通讯作者：
Di Minno, Matteo Nicola Dario
中科院分区：
文献类型：
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作者：
Ambrosino, Pasquale;Tasso, Marco;Di Minno, Matteo Nicola Dario
导论.类风湿性关节炎（RA）患者的心血管（CV）发病率和死亡率增加。脉搏波速度（PWV）和增强指数（AIx）是评估动脉硬度（CV风险的标志物）的无创方法。我们进行了一项荟萃分析，评估RA对动脉-PWV、肱动脉-PWV、肱踝（ba-）PWV、AIx和标准化为75次/分钟心率（AIx@75）的AIx的影响。系统检索了评价RA与动脉-PWV、肱动脉-PWV、ba-PWV、AIx和AIx@75之间关系的研究。共纳入25项研究（1，472例RA患者，1，583例对照）。与对照组相比，RA患者表现出显著更高的动脉PWV（平均差异1.32 m/s; 95% CI 0.77，1.88; P < 0.00001），ba-PWV（MD 198.42 cm/s; 95% CI 45.79，342.76; P = 0.01），AIx（MD 11.50%; 95% CI 5.15，17.86; P = 0.0004）和AIx@75（MD 6.99%; 95% CI 4.92，9.06; P < 0.00001），具有更高的肱动脉PWV趋势（MD 0.34 m/s; 95% CI-0.03，0.70; P = 0.07）。在分析早期RA的研究时，RA患者和对照组的平均PWV差异更大（MD 2.30 m/s; 95%CI 1.15，3.45; P < 0.0001）。荟萃回归分析显示，更严重的炎症状态影响动脉瘤PWV、AIx和AIx@75。RA患者的动脉僵硬度（CV风险的公认标志物）增加。这种改变与炎症状态的严重程度相关，甚至在早期疾病中也存在。
Introduction. Patients with rheumatoid arthritis (RA) have an increased cardiovascular (CV) morbidity and mortality. Pulse-wave velocity (PWV) and augmentation index (AIx) are non-invasive methods to assess arterial stiffness, a marker of CV risk. We performed a meta-analysis evaluating the impact of RA on aortic-PWV, brachial-PWV, brachial-ankle (ba-) PWV, AIx, and AIx normalized to a 75 beats/minute heart rate (AIx@ 75).Materials and Methods. Studies evaluating the relationship between RA and aortic-PWV, brachial-PWV, ba-PWV, AIx, and AIx@ 75 were systematically searched. A total of 25 studies (1,472 RA patients, 1,583 controls) were included.Results. Compared to controls, RA patients showed a significantly higher aortic-PWV (mean difference 1.32 m/s; 95% CI 0.77, 1.88; P < 0.00001), ba-PWV (MD 198.42 cm/s; 95% CI 45.79, 342.76; P = 0.01), AIx (MD 11.50%; 95% CI 5.15, 17.86; P = 0.0004), and AIx@ 75 (MD 6.99%; 95% CI 4.92, 9.06; P < 0.00001), with a trend toward a higher brachial-PWV (MD 0.34 m/s; 95% CI -0.03, 0.70; P = 0.07). When analyzing studies on early RA, the difference in aortic-PWV among RA patients and controls was even higher (MD 2.30 m/s; 95% CI 1.15, 3.45; P < 0.0001).Conclusion. Meta-regression showed that a more severe inflammatory status impacted on aortic-PWV, AIx, and AIx@ 75. Arterial stiffness, a recognized marker of CV risk, is increased in RA patients. This alteration is associated with the severity of the inflammatory status and is present even in early-stage disease.