High ten-year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients: a population-based cohort study.
High ten-year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients: a population-based cohort study.
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DOI：
10.1002/art.23650
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发表时间：
2008-08
影响因子：
--
通讯作者：
Gabriel, Sherine E.
中科院分区：
文献类型：
--
作者：
Kremers, Hilal Maradit;Crowson, Cynthia S.;Therneau, Terry M.;Roger, Veronique L.;Gabriel, Sherine E.
本研究的目的是评估新诊断的类风湿关节炎（RA）患者10年心血管（CV）事件的绝对风险，以及心血管危险因素对绝对风险评估的潜在影响。
组建了一个基于人群的类风湿关节炎发病队列（根据美国风湿病学会标准确定），并与年龄和性别匹配的非类风湿关节炎队列进行比较。收集了心血管危险因素和心血管事件的数据。使用考克斯回归模型评估综合心血管终点的10年风险，并对心血管危险因素进行校正。根据10年绝对风险将患者分为5个风险类别。
类风湿关节炎患者的心血管绝对风险与年龄大5 - 10岁的非类风湿关节炎患者相似。心血管绝对风险因心血管危险因素的存在而有很大差异。60 - 69岁无心血管危险因素的类风湿关节炎患者10年心血管绝对风险为16.8%，但在存在吸烟、高血压、血脂异常、糖尿病和肥胖的情况下，风险上升至60.4%。在体重指数（BMI）低（与正常或高BMI相比）且存在上述危险因素的类风湿关节炎患者中，10年心血管绝对风险上升至86.2%。
在50 - 59岁新诊断的类风湿关节炎患者中，超过一半以及所有60岁以上的患者在未来10年内患心血管疾病的风险为10%或更高，应根据其个人风险状况制定针对性的心血管风险降低策略。
The purpose of this study was to estimate the 10-year absolute risk of CV events in newly diagnosed RA subjects and the potential contribution of CV risk factors to absolute risk assessment. A population-based incidence cohort of RA subjects (ascertained according to ACR criteria) was assembled and compared to an age and sex-matched cohort of non-RA subjects. Data were collected on CV risk factors and CV events. Cox regression models were used to estimate the 10-year risk of a combined CV endpoint, adjusting for CV risk factors. Subjects were classified into 5 risk categories based on their 10-year absolute risk. The absolute CV risk in RA subjects was similar to that of non-RA subjects who were 5-10 years older. The absolute risk varied substantially according to presence of CV risk factors. The 10-year absolute CV risk among 60-69 year old RA subjects with no risk factors was 16.8% but rose to 60.4% in the presence of smoking, hypertension, dyslipidemia, diabetes and obesity. Among RA subjects with low, as compared to normal or high BMI, in addition to the above risk factors, the 10-year absolute CV risk rose to 86.2%. More than half of 50-59 year old newly diagnosed RA subjects and all of those >60 years of age had a 10% or greater risk of CV disease within the next 10 years and should be targeted for specific CV risk reduction strategies tailored to their personal risk profiles.
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影响因子：
16.2
作者：
Coleman, Ruth L.;Stevens, Richard J.;Holman, Rury R.
通讯作者：
Holman, Rury R.
影响因子：
--
作者：
Crowson, CS;Nicola, PJ;Gabriel, SE
通讯作者：
Gabriel, SE
影响因子：
3.7
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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120.7
作者：
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通讯作者：
Murray, EZ