Improved Incidence of Cardiovascular Disease in Patients With Incident Rheumatoid Arthritis in the 2000s: A Population-based Cohort Study.
Improved Incidence of Cardiovascular Disease in Patients With Incident Rheumatoid Arthritis in the 2000s: A Population-based Cohort Study.
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DOI：
10.3899/jrheum.200842
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Crowson CS
中科院分区：
文献类型：
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作者：
Myasoedova E;Davis JM;Roger VL;Achenbach SJ;Crowson CS
评估1980-2009年发病的类风湿性关节炎(RA)患者与非RA患者心血管疾病(CVD)事件发生后的发病率和死亡率的趋势。我们研究了明尼苏达州奥姆斯特德县的RA发病居民(年龄≥18岁，1987年符合ACR标准)和来自相同来源人群、年龄、性别和日历年指数相似的非RA受试者。所有受试者都被跟踪调查，直到死亡、迁徙或2016年12月31日。心血管事件包括心肌梗死和中风。排除在RA发病/指数日期之前有心血管疾病的患者。使用COX模型按十年比较发生的心血管事件，调整了年龄、性别和心血管疾病危险因素。这项研究包括905名RA患者和904名非RA受试者。与20世纪80年代相比，21世纪初突发类风湿性关节炎患者任何心血管事件的累积发生率都较低。2000年与1980年代任何心血管事件的危险比[HR]：0.53；95%可信区间(CI)：0.31-0.93。调整抗风湿药物使用后关联强度减弱：HR为0.64，95%CI为0.34-1.22。2000年代的类风湿性关节炎患者与非类风湿性关节炎患者相比，心血管疾病的发生率没有增加(HR：0.71，95%CI：0.42-1.19)。与80年代相比，80年代以后的RA患者发生心血管事件后死亡的风险有所降低：20世纪90年代的HR：0.54，95%CI：0.33-0.90；2000年代的HR：0.68，95%CI：0.33-1.41。近几十年来，RA主要心血管事件的发生率有所下降。类风湿性关节炎患者与普通人群之间的心血管疾病发生率差距正在缩小。RA发生心血管事件后的死亡率可能正在改善。
To assess trends in incidence of cardiovascular disease (CVD) and mortality following incident CVD events in patients with rheumatoid arthritis (RA) onset in 1980–2009 versus non-RA subjects. We studied Olmsted County, Minnesota residents with incident RA (age ≥18 years, 1987 ACR criteria met in 1980–2009) and non-RA subjects from the same source population with similar age, sex and calendar year of index. All subjects were followed until death, migration, or 12/31/2016. Incident CVD events included myocardial infarction and stroke. Patients with CVD before RA incidence/index date were excluded. Cox models were used to compare incident CVD events by decade, adjusting for age, sex and CVD risk factors. The study included 905 patients with RA and 904 non-RA subjects. Cumulative incidence of any CVD event was lower in patients with incident RA in 2000s versus 1980s. Hazard Ratio [HR] for any incident CVD 2000s versus 1980s: 0.53; 95% confidence interval (CI): 0.31–0.93. The strength of association attenuated after adjustment for anti-rheumatic medication use: HR 0.64, 95%CI 0.34–1.22. Patients with RA in 2000s had no excess in CVD over non-RA subjects (HR: 0.71, 95%CI:0.42–1.19). Risk of death after a CVD event was somewhat lower in patients with RA after 1980s: HR: 0.54, 95%CI:0.33–0.90 in 1990s and HR: 0.68, 95%CI:0.33–1.41 in 2000s versus 1980s. Incidence of major CVD events in RA has declined in recent decades. The gap in CVD occurrence between RA patients and the general population is closing. Mortality after CVD events in RA may be improving.
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影响因子：
--
作者：
Myasoedova, Elena;Crowson, Cynthia S.;Kremers, Hilal Maradit;Therneau, Terry M.;Gabriel, Sherine E.
通讯作者：
Gabriel, Sherine E.
影响因子：
27.4
作者：
Burggraaf, Benjamin;van Breukelen-van der Stoep, Deborah F.;Cabezas, Manuel Castro
通讯作者：
Cabezas, Manuel Castro
影响因子：
3.9
作者：
Avouac, Jerome;Meune, Christophe;Allanore, Yannick
通讯作者：
Allanore, Yannick
影响因子：
5.5
作者：
Meune, Christophe;Touze, Emmanuel;Allanore, Yannick
通讯作者：
Allanore, Yannick
影响因子：
3.9
作者：
Myasoedova, Elena;Gabriel, Sherine E.;Crowson, Cynthia S.
通讯作者：
Crowson, Cynthia S.