LUPUS COHORT-THROMBOTIC EVENTS & CORONARY ARTERY DISEASE

狼疮队列血栓事件

• 批准号: 3473640
• 负责人: MICHELLE A PETRI
• 金额: $ 11.74万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-30 至 1996-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3473640
• 关键词: blood coagulation tests; coronary disorder; disease /disorder proneness /risk; drug adverse effect; family genetics; female; gender difference; human age group; human subject; hyperlipidemia; hypertension; immunogenetics; lifestyle; longitudinal human study; male; medical complication; obesity; oral contraceptives; prednisone; socioeconomics; statistics /biometry; systemic lupus erythematosus; thrombosis; tobacco abuse; urinalysis; vasculitis

The Johns Hopkins Lupus Cohort is a longitudinal study, begun by Dr. Petri in 1987, of the incidence and pathogenesis of thrombotic events (TE) and coronary artery disease (CAD) in 225 patients with systemic lupus erythematosus (SLE) (60.2% black, 90.5% female, mean age 36.5 years). In SLE, both TE and CAD are a major cause of morbidity. The usual natural history of TE and CAD is telescoped, so that patients can present with these outcomes in their third and fourth decades. In our cohort study to date, 44 patients, have had past and 10 patients have had prospectively-followed thrombotic events. Thirteen patients (6.6%) have had coronary artery disease. We have prospectively followed our lupus cohort routinely every three months and have amassed a four-year database specifically designed to identify and to follow over time the most important risk factors for TE and CAD. Risk factors to be addressed in the study include: 1) the hypercoagulable state secondary to antiphospholipid antibodies (the lupus anticoagulant and anticardiolipin antibody); 2) premature atherosclerosis, accelerated by prednisone and hypertension; 3) underlying vascular damage from lupus vasculopathy and vasculitis; 4) co-morbid factors, including obesity, smoking, hyperlipidemia, hypertension, sedentary life style, and family history of CAD, and 5) other factors, including sex, age, race, immunogenetics, compliance with medication, and socioeconomic status. The Hopkins Cohort Study is uniquely able to focus on these issues, both because of its population, which reflects a broad racial, educational, and socioeconomic background, and because the four years of data accumulated to date show promising preliminary results. The five years of the proposed study will allow us to address further the incidence of TE and CAD, the importance of identified risk factors both singly and in combination, and to begin to address the issue of intervention to modify and reduce risk factors.

约翰·霍普金斯狼疮队列研究是一项纵向研究，由佩里博士开始 1987年，血栓形成事件(TE)和血栓形成事件的发生率和发病机制 225例系统性红斑狼疮患者的冠状动脉病变 红斑狼疮(SLE)(黑人占60.2%，女性占90.5%，平均年龄36.5岁)。在……里面 系统性红斑狼疮、TE和CAD都是发病的主要原因。往常的自然 TE和CAD的历史被折叠起来，以便患者可以呈现 这些成果在它们的第三和四十年里。在我们的队列研究中 日期，44名患者，过去有过，10名患者有 前瞻性跟踪血栓事件。13名患者(6.6%)有 患有冠状动脉疾病。我们前瞻性地跟踪了我们的狼疮 每三个月定期进行一次队列调查，并积累了一个四年的数据库 专门设计用于识别和跟踪随时间推移最多的 血栓栓塞症和冠心病的重要危险因素。需要解决的风险因素 研究包括：1)继发于抗磷脂的高凝状态 抗体(狼疮抗凝剂和抗心磷脂抗体)；2) 动脉粥样硬化过早，强的松和高血压加速；3) 狼疮血管病和血管炎引起的潜在血管损害；4) 共病因素，包括肥胖、吸烟、高脂血症、 高血压、久坐不动的生活方式和冠心病家族史，以及其他 因素，包括性别、年龄、种族、免疫遗传学、遵守 药物和社会经济地位。霍普金斯的队列研究是独一无二的 能够专注于这些问题，既是因为它的人口，也是因为它 反映了广泛的种族、教育和社会经济背景，以及 因为迄今为止积累的四年数据显示前景看好 初步结果。拟议研究的五年将使我们能够 进一步解决血栓栓塞症和冠心病的发生率，确定 风险因素既有单独的，也有组合的，并开始解决 修改和减少风险因素的干预问题。