Heart involvement in Rheumatoid Arthritis: Systematic review and meta-analysis
Heart involvement in Rheumatoid Arthritis: Systematic review and meta-analysis
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DOI：
10.1016/j.ijcard.2012.05.057
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发表时间：
2013-09-01
影响因子：
3.5
通讯作者：
Licata, Giuseppe
中科院分区：
文献类型：
--
作者：
Corrao, Salvatore;Messina, Silvia;Licata, Giuseppe
目的：我们的研究的目的是进行一个系统的回顾与荟萃分析，目前的病例对照研究有关的瓣膜和心包参与风湿性关节炎（RA）患者，无症状的心血管diseases.Methods：病例对照研究，通过检索PubMed（1975 - 2010）和科克伦中央注册对照试验（CENTRAL）（1975 - 2010）。研究对象为无心血管疾病症状的RA成人患者，以心脏受累为评价指标。结果：从2326篇文献中检索到10篇相关研究，RA与心包积液显著相关，RA与心包积液显著相关（OR 10.7; 95%CI 5.0 - 23.0），瓣膜结节（OR 12.5; 95% CI 2.8 - 55.4），三尖瓣关闭不全（OR 5.3; 95% CI 2.4 - 11.6），主动脉瓣狭窄（OR 5.2; 95% CI 1.1 - 24.1），二尖瓣关闭不全（OR 3.4; 95% CI 1.7 - 6.7），主动脉瓣关闭不全（OR 1.7; 95% CI 1.0 - 2.7），联合瓣膜改变（OR 4.3; 95% CI 2.3 - 8.0），二尖瓣增厚和/或钙化（OR 5.0; 95% CI 2.0 - 12.7），主动脉瓣增厚和/或钙化（OR 4.4; 95% CI 1.1 - 17.4），瓣膜增厚和/或钙化（OR 4.8; 95% CI 2.2 - 10.5）和二尖瓣脱垂结论：我们的系统评价指出了RA患者心包和心脏瓣膜受累的强度和级别。我们的研究结果强调了超声心动图评估的重要性，至少在临床研究中，当RA患者参与。此外，还需要进一步的研究来了解我们的发现与心血管死亡率增加的可能关系。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Objective: The aim of our study was to conduct a systematic review with meta-analysis of the current case-control studies about the valvular and pericardial involvement in patients with Rheumatoid Arthritis (RA), asymptomatic for cardiovascular diseases.Methods: Case-control studies were identified by searching PubMed (1975-2010) and the Cochrane Central Register of Controlled Trials (CENTRAL) (1975-2010). Participants were adult patients with RA asymptomatic for cardiovascular diseases, and the outcome measure was the presence of cardiac involvement.Results: Quantitative synthesis included 10 relevant studies out of 2326 bibliographic citations that had been found. RA resulted significantly associated to pericardial effusion (OR 10.7; 95% CI 5.0-23.0), valvular nodules (OR 12.5; 95% CI 2.8-55.4), tricuspidal valve insufficiency (OR 5.3; 95% CI 2.4-11.6), aortic valve stenosis (OR 5.2; 95% CI 1.1-24.1), mitral valve insufficiency (OR 3.4; 95% CI 1.7-6.7), aortic valve insufficiency (OR 1.7; 95% CI 1.0-2.7), combined valvular alterations (OR 4.3; 95% CI 2.3-8.0), mitral valve thickening and/or calcification (OR 5.0; 95% CI 2.0-12.7), aortic valve thickening and/or calcification (OR 4.4; 95% CI 1.1-17.4), valvular thickening and/or calcification (OR 4.8; 95% CI 2.2-10.5), and mitral valve prolapse (OR 2.2; 95% CI 1.2-4.0).Conclusions: Our systematic review pointed out the strength and the grade of both pericardial and cardiac valvular involvement in RA patients. Our findings underscore the importance of an echocardiographic assessment at least in clinical research when RA patients are involved. Moreover, further research is needed to understand the possible relationship of our findings and the increased cardiovascular mortality. (C) 2012 Elsevier Ireland Ltd. All rights reserved.