Increased coronary-artery atherosclerosis in rheumatoid arthritis - Relationship to disease duration and cardiovascular risk factors
Increased coronary-artery atherosclerosis in rheumatoid arthritis - Relationship to disease duration and cardiovascular risk factors
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DOI：
10.1002/art.21288
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发表时间：
2005-10-01
影响因子：
--
通讯作者：
Stein, CM
中科院分区：
文献类型：
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作者：
Chung, CP;Oeser, A;Stein, CM
目标。比较早期和确诊的类风湿关节炎（RA）患者与对照组冠状动脉粥样硬化的患病率和严重程度。使用电子束计算机断层扫描测量227名受试者的冠状动脉钙化程度，其中70名为早期RA， 71名为已确诊RA， 86名为对照组。比较Agatston钙化评分计算的冠状动脉钙化情况，并探讨其与临床特征的关系。校正优势比（ORs）使用比例优势logistic回归模型来确定早期和已建立的RA与冠状动脉钙化的独立关联。与早期疾病患者（中位数0，IQR 0-42.6）和对照组（中位数0，IQR 0-19.2）相比，已确诊RA患者的钙评分（中位数40.2，四分位数范围[IQR] 0-358.8）更高（P = 0.001）。确诊类风湿性关节炎患者发生冠状动脉钙化的频率（60.6%）高于早期类风湿性关节炎患者（42.9%）和对照组（38.4%）（P = 0.016）。在调整心血管危险因素后，确诊类风湿性关节炎患者发生更严重冠状动脉钙化的可能性（定义为Agatston评分bb0 109）的OR为3.42 （P = 0.002）。在RA患者中，调整年龄和性别后，吸烟（OR 1.02, P = 0.04）和红细胞沉降率升高（OR 1.02, P = 0.05）与更严重的冠状动脉钙化相关。在已确诊的类风湿性关节炎患者中，冠状动脉钙化的患病率和严重程度增加，部分与吸烟和红细胞沉降率增加有关。
Objective. To compare the prevalence and severity of coronary-artery atherosclerosis in patients with early and established rheumatoid arthritis (RA) and controls.Methods. Electron-beam computed tomography was used to measure the extent of coronary-artery calcification in 227 subjects, of whom 70 had early RA, 71 had established RA, and 86 were controls. Coronary-artery calcification calculated according to the Agatston calcium score was compared in patients and controls, and its relationship to clinical characteristics was examined. Adjusted odds ratios (ORs) were obtained with the use of proportional odds logistic regression models to determine independent associations of early and established RA and coronary-artery calcification.Results. Calcium scores were higher in patients with established RA (median 40.2, interquartile range [IQR] 0-358.8) compared with those with early disease (median 0, IQR 0-42.6) and controls (median 0, IQR 0-19.2) (P = 0.001). Coronary-artery calcification occurred more frequently in patients with established RA (60.6%) than in patients with early RA (42.9%) and control subjects (38.4%) (P = 0.016) The OR for the likelihood of having more severe coronary-artery calcification (defined as an Agatston score > 109) in patients with established disease was 3.42 (P = 0.002) after adjusting for cardiovascular risk factors. Among patients with RA, smoking (OR 1.02, P = 0.04) and an elevated erythrocyte sedimentation rate (OR 1.02, P = 0.05) were associated with more severe coronary-artery calcification after adjustment for age and sex.Conclusion. The prevalence and severity of coronary calcification is increased in patients with established RA and is related, in part, to smoking and an increased erythrocyte sedimentation rate.