Factors associated with arterial vascular events in PROFILE: a Multiethnic Lupus Cohort.
Factors associated with arterial vascular events in PROFILE: a Multiethnic Lupus Cohort.
复制标题
DOI：
10.1177/0961203309104862
复制
发表时间：
2009-10
期刊：
影响因子：
2.6
通讯作者：
PROFILE Study Group
中科院分区：
文献类型：
--
作者：
Bertoli AM;Vilá LM;Alarcón GS;McGwin G;Edberg JC;Petri M;Ramsey-Goldman R;Reveille JD;Kimberly RP;PROFILE Study Group
本研究的目的是确定与多种族系统性红斑狼疮（SLE）队列中动脉血管事件发生相关的因素。PROFILE队列研究由来自5个不同美国机构的确定种族的SLE患者（n= 1，333）组成，以确定与血管事件相关的人口统计学、临床和生物学变量。动脉血管事件（首次发作）为心肌梗死、心绞痛和/或心肌梗死的血管手术、卒中、跛行和/或坏疽证据。通过单变量和多变量考克斯比例风险回归分析来分析患者特征。123例（9.8%）患者至少发生1起动脉事件。队列入组时的年龄（HR= 1.04，95%CI 1.03-1.06）、吸烟（HR= 2.20，95%CI 1.40-3.46）和CRP 2 * C等位基因（HR= 1.91，95%CI 1.04-3.49）与动脉血管事件发生时间较短相关。疾病活动的一些临床表现与较短的发病时间[精神病]相关（HR= 2.21，95% CI 1.10-4.44），癫痫发作（HR= 1.85，95%CI 1.00-3.24）和贫血（HR= 1.83，95%CI 1.02-3.31）]，而其他则无[关节炎（HR= 0.32，95%CI 0.18-0.58）]。总之，老年患者，特别是在易感环境因素（吸烟）和严重临床表现的背景下，发生动脉血管事件的风险更高。CRP基因座变异的遗传贡献不被人口统计学或临床变量所掩盖。对这些因素的认识应该会导致对有动脉血管事件风险的患者采取更有效的管理策略。
The objective of this study was to determine the factors associated with the occurrence of arterial vascular events in a multiethnic systemic lupus erythematosus (SLE) cohort. The PROFILE cohort, comprised of SLE patients (n=1,333) of defined ethnicity from five different U.S. institutions, was studied to determine demographic, clinical and biological variables associated with vascular events. An arterial vascular event (first episode) was either a myocardial infarction, angina pectoris and/or a vascular procedure for myocardial infarction, stroke, claudication and/or evidence of gangrene. Patient characteristics were analyzed by univariable and multivariable Cox proportional hazards regression analyses. One-hundred twenty-three (9.8%) patients had at least one incident arterial event. Age at cohort enrollment (HR= 1.04, 95% CI 1.03-1.06), smoking (HR= 2.20, 95% CI 1.40-3.46), and the CRP2* C alleles (HR= 1.91, 95%CI 1.04-3.49) were associated with a shorter time-to-the occurrence of arterial vascular events. Some clinical manifestations of disease activity were associated with a shorter time-to-occurrence [psychosis (HR= 2.21, 95% CI 1.10-4.44), seizures (HR= 1.85, 95% CI 1.00-3.24) and anemia (HR= 1.83, 95% CI 1.02-3.31)], but others were not [arthritis (HR= 0.32, 95% CI 0.18-0.58)]. In conclusion, older patients, especially in the context of a predisposing environmental factor (smoking) and severe clinical manifestations, are at higher risk of having arterial vascular events. The genetic contribution of the variation at the CRP locus was not obscured by demographic or clinical variables. Awareness of these factors should lead to more effective management strategies of patients at risk for arterial vascular events.
登录
查看更多内容
DOI：
10.1002/art.22766
发表时间：
2007-06-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Booth, Stephanie;Chohan, Saima;Utset, Tammy O.
通讯作者：
Utset, Tammy O.
影响因子：
20.3
作者：
Brouwer, JLR;Bijl, M;van der Meer, J
通讯作者：
van der Meer, J
影响因子：
8.3
作者：
COCITO, L;FAVALE, E;RENI, L
通讯作者：
RENI, L
影响因子：
2.8
作者：
Bermudez, EA;Rifai, N;Ridker, PM
通讯作者：
Ridker, PM
影响因子：
5.5
作者：
Bessant, R;Hingorani, A;Rahman, A
通讯作者：
Rahman, A