Noncardiac vascular disease in rheumatoid arthritis: Increase in venous thromboembolic events?
Noncardiac vascular disease in rheumatoid arthritis: Increase in venous thromboembolic events?
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DOI：
10.1002/art.33322
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发表时间：
2012-01-01
影响因子：
--
通讯作者：
Matteson, Eric L.
中科院分区：
文献类型：
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作者：
Bacani, A. Kirstin;Gabriel, Sherine E.;Matteson, Eric L.
目的了解社区类风湿关节炎(RA)患者非心血管疾病的发病率，并与普通人群进行比较，探讨RA患者非心血管疾病的发病趋势。对明尼苏达州奥姆斯特德县1980年1月1日至2007年12月31日期间发生的类风湿性关节炎患者和来自相同人群的非类风湿性关节炎患者进行了基于人群的初始队列，并进行了跟踪调查，直至2008年12月31日。通过病历复习确定静脉血栓、脑血管和外周动脉事件。研究人群包括813名RA患者，平均+/-SD年龄为55.9+/-15.7岁(68%为女性)，平均随访时间为9.6+/-6.9年。与年龄和性别相似的非RA患者相比，1995年至2007年间被诊断为RA的患者静脉血栓栓塞症的发生率(%)更高(累积发病率分别为+/-SE6.7+/-1.7vs2.8+/-1.1vs2.8+/-1.1vs2.8+/-1.1vs2.8+/-1.1vs2.8+/-1.1vs2.8+/-1.1vs2.8+/-1.1vs.P=0.005)，但脑血管和外周动脉事件的发生率相似。在类风湿关节炎患者中，1995-2007年期间静脉血栓、脑血管和外周动脉事件的发生率与1980-1994年期间相似。我们的研究结果表明，与非RA患者相比，RA患者静脉血栓栓塞症的发生率增加。类风湿性关节炎患者脑血管事件和外周血管疾病事件的发生率与非类风湿性关节炎患者相似。在类风湿关节炎患者中，非心血管疾病的发病率在近几十年来保持稳定。
Objective To investigate the incidence of noncardiac vascular disease in a community-based incidence cohort of patients with rheumatoid arthritis (RA) and compare it to that in the general population and to investigate trends in the incidence of noncardiac vascular disease in patients with RA.Methods. A population-based inception cohort of patients with incident RA between January 1, 1980 and December 31, 2007 in Olmsted County, Minnesota and a cohort of non-RA subjects from the same population base was assembled and followed up until December 31, 2008. Venous thromboembolic, cerebrovascular, and peripheral arterial events were ascertained by medical record review.Results. The study population included 813 patients with RA with a mean +/- SD age of 55.9 +/- 15.7 years (68% women) and an average length of followup of 9.6 +/- 6.9 years. Compared to non-RA subjects of similar age and sex, patients diagnosed as having RA between 1995 and 2007 had a higher incidence (%) of venous thromboembolism (cumulative incidence +/- SE 6.7 +/- 1.7 versus 2.8 +/- 1.1, respectively; P = 0.005) but similar rates of cerebrovascular and peripheral arterial events. Among patients with RA, the incidence of venous thromboembolic, cerebrovascular, and peripheral arterial events was similar in the 1995-2007 time period compared to the 1980-1994 time period.Conclusion. Our findings indicate that the incidence of venous thromboembolism is increased in patients with RA compared to non-RA subjects. The incidence of cerebrovascular events and peripheral vascular disease events is similar in patients with RA compared to non-RA subjects. Among patients with RA, the incidence of noncardiac vascular disease has remained stable in recent decades.