Giant cell arteritis and cardiovascular disease in older adults

Giant cell arteritis and cardiovascular disease in older adults
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DOI：
10.1136/hrt.2004.037481
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发表时间：
2005-03-01
期刊：
HEART
影响因子：
5.7
通讯作者：
Geerts, WH
Geerts, WH
中科院分区：
医学1区
文献类型：
--
作者：
Ray, JG;Mamdani, MM;Geerts, WH

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目的：探讨老年人巨细胞动脉炎（GCA）与随后心血管疾病之间的关系。设计：基于人群的回顾性队列研究。设定：整个加拿大安大略省。参与者：年龄66岁及以上的新诊断GCA（n = 1141），骨关节炎（n = 172 953），或两者都没有（n = 200 000）的患者。从普通人群中随机选择两种疾病都不存在的患者作为对照组。主要结果指标：主要复合结果是基于冠状动脉疾病、中风、外周动脉疾病、动脉瘤或主动脉夹层的后续诊断或手术治疗。复合终点在GCA老年患者中（12.1/ 1000人-年）比骨关节炎患者（7.3/1000人-年）或两种疾病都没有的患者（5.3/1000人-年）更常见。GCA患者与骨关节炎患者的心血管疾病的校正风险比为1.6（95%置信区间（CI）1.1至2.2），GCA患者与未受影响的对照组的风险比为2.1（95% CI 1.5至3.0）。积极的心血管危险因素改变方法是否对这些患者特别有益仍有待确定。
Objective: To explore the association between giant cell arteritis ( GCA) and subsequent cardiovascular disease in older adults.Design: Population based retrospective cohort study. Setting: The entire province of Ontario, Canada.Participants: Patients aged 66 years and older with newly diagnosed GCA ( n = 1141), osteoarthritis ( n = 172 953), or neither ( n = 200 000). Patients with neither were randomly selected from the general population and formed the control group.Main outcome measures: The primary composite outcome was based on a subsequent diagnosis or surgical treatment for coronary artery disease, stroke, peripheral arterial disease, or aneurysm or dissection of the aorta.Results: The composite end point was more common in seniors with GCA ( 12.1/ 1000 person-years) than in patients with osteoarthritis ( 7.3/1000 person-years) or neither condition ( 5.3/1000 person-years). The adjusted hazard ratio for cardiovascular disease was 1.6 ( 95% confidence interval ( CI) 1.1 to 2.2) in patients with GCA versus patients with osteoarthritis, and 2.1 ( 95% CI 1.5 to 3.0) in patients with GCA versus unaffected controls.Conclusions : Older adults with GCA appear to be at increased risk for developing cardiovascular disease. Whether an aggressive approach to cardiovascular risk factor modification is particularly beneficial in these patients remains to be determined.