Subclinical atherosclerosis in patients with rheumatoid arthritis
Subclinical atherosclerosis in patients with rheumatoid arthritis
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类风湿性关节炎患者的亚临床动脉粥样硬化
DOI：
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发表时间：
2015
影响因子：
6.7
通讯作者：
M. D. Di Minno
中科院分区：
文献类型：
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作者：
P. Ambrosino;R. Lupoli;A. Di Minno;M. Tasso;R. Peluso;M. D. Di Minno
我们对类风湿关节炎(RA)对颈总动脉内膜中层厚度(CCAIMT)和颈动脉斑块患病率的影响进行了系统的荟萃分析和文献回顾。系统检索PubMed、Web of Science、Scope us和EMBASE数据库，评价RA与心血管危险标记物(CCA-IMT和颈动脉斑块患病率)之间关系的研究。共有59项研究(4317名RA患者和3606名对照)进入最终分析，51项关于CCA-IMT的研究(3600名RA患者和3020名对照的52个数据集)和35项关于颈动脉斑块患病率的研究(2859名RA患者和2303名对照)。与对照组相比，类风湿性关节炎患者颈动脉内中膜厚度增加(平均差值：0.1 mm；95%可信区间：0.07，0.12；P<；0.00001)，颈动脉斑块患病率增加(优势比：3.6；95%CI：2.65，4.93；P<；0.00001)。有趣的是，在分析有关早期RA的研究时，RA患者和对照组之间的颈动脉IMT差异更大(MD：0.21 mm；95%CI：0.06，0.35；p=0.006)，并且完全证实了颈动脉斑块患病率的差异(OR：3.57；95%CI：1.69，7.51；p=0.0008)。Meta回归模型显示，男性性别和炎症状态较重[如28个关节的疾病活动评分(DAS28)、C反应蛋白(CRP)水平和血沉(ESR)]对CCA-IMT有显著影响。综上所述，类风湿关节炎似乎与亚临床动脉粥样硬化和心血管风险显著相关。这些发现有助于制定适当的预防策略和治疗方法。
Summary We performed a systematic review with meta-analysis and meta-regression of literature studies evaluating the impact of rheumatoid arthritis (RA) on common carotid artery intima-media thickness (CCAIMT) and on the prevalence of carotid plaques. Studies evaluating the relationship between RA and markers of cardiovascular (CV) risk (CCA-IMT and prevalence of carotid plaques) were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases. A total of 59 studies (4,317 RA patients and 3,606 controls) were included in the final analysis, 51 studies with data on CCA-IMT (52 data-sets on 3,600 RA patients and 3,020 controls) and 35 studies reporting on the prevalence of carotid plaques (2,859 RA patients and 2,303 controls). As compared to controls, RA patients showed a higher CCA-IMT (mean difference [MD]: 0.10 mm; 95 % confidence interval [CI]: 0.07, 0.12; p < 0.00001), and an increased prevalence of carotid plaques (odds ratio [OR]: 3.61; 95 %CI: 2.65, 4.93; p< 0.00001). Interestingly, when analysing studies on early RA, the difference in CCAIMT among RA patients and controls was even higher (MD: 0.21 mm; 95 %CI: 0.06, 0.35; p=0.006), and difference in the prevalence of carotid plaques was entirely confirmed (OR: 3.57; 95 %CI: 1.69, 7.51; p=0.0008). Meta-regression models showed that male gender and a more severe inflammatory status [as expressed by disease activity score in 28 joints (DAS28), C-reactive protein (CRP) levels, and erythrocyte sedimentation rate (ESR)] significantly impacted on CCA-IMT. In conclusion, RA appears significantly associated with subclinical atherosclerosis and CV risk. These findings can be useful to plan adequate prevention strategies and therapeutic approaches.
影响因子：
5
作者：
Chambless, LE;Heiss, G;Clegg, LX
通讯作者：
Clegg, LX
影响因子：
158.5
作者：
O'Leary, DH;Polak, JF;Wolfson, SK
通讯作者：
Wolfson, SK