父母病史对类风湿关节炎患者心血管死亡率的影响。

Impact of parental history on patients' cardiovascular mortality in rheumatoid arthritis.

作者信息

Björnådal L, Brandt L, Klareskog L, Askling J

机构信息

Rheumatology Unit, Department of Medicine, Karolinska University Hospital Solna, and Karolinska Institutet, Stockholm, Sweden.

出版信息

Ann Rheum Dis. 2006 Jun;65(6):741-5. doi: 10.1136/ard.2005.039990. Epub 2005 Oct 25.

DOI:10.1136/ard.2005.039990

PMID:16249229

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1798172/

Abstract

BACKGROUND

Patients with rheumatoid arthritis are at increased risk of death from cardiovascular disease (CVD). This risk is influenced by the inflammatory activity of the rheumatoid arthritis as well as by traditional risk factors for CVD. However, little is known about whether or to what extent hereditary factors for CVD contribute additional risk in patients with rheumatoid arthritis.

OBJECTIVE

To assess the clinical impact of a parental history of CVD in patients with rheumatoid arthritis.

METHODS

Population based cohort study of 10,805 Swedish patients with rheumatoid arthritis aged 16-67 years during follow up (1990-2000). Parents, and cardiovascular deaths among patients and parents, were identified through register linkages. Relative risk of death v the general population was assessed using standardised mortality ratios (SMR), which were compared by Poisson regression.

RESULTS

Rheumatoid patients with a parental history of fatal CVD had an SMR of death from CVD of 2.9 (95% confidence interval, 2.5 to 3.4). By contrast, rheumatoid patients without a parental history of fatal CVD had an SMR of 1.7 (1.2 to 2.3). A parental death from CVD was associated with a 70% increase in the risk of fatal CVD in rheumatoid arthritis (SMR ratio = 1.7 (1.2 to 2.4), and an increase in the 10 year mortality from CVD from 5% to 10% in men and from 2% to 4% in women aged 50 to 67 years.

CONCLUSIONS

Parental history of death from CVD is an important (and easily assessable) risk factor for fatal CVD in rheumatoid arthritis.

摘要

背景

类风湿关节炎患者死于心血管疾病（CVD）的风险增加。这种风险受类风湿关节炎的炎症活动以及CVD的传统风险因素影响。然而，关于CVD的遗传因素在类风湿关节炎患者中是否会增加额外风险或增加到何种程度，目前知之甚少。

目的

评估类风湿关节炎患者有心血管疾病家族史的临床影响。

方法

对10805名年龄在16 - 67岁的瑞典类风湿关节炎患者进行基于人群的队列研究（随访时间为1990 - 2000年）。通过登记关联确定患者及其父母的心血管死亡情况。使用标准化死亡率（SMR）评估相对于普通人群的死亡相对风险，并通过泊松回归进行比较。

结果

有父母死于致命性CVD家族史的类风湿患者因CVD死亡的SMR为2.9（95%置信区间，2.5至3.4）。相比之下，无父母死于致命性CVD家族史的类风湿患者的SMR为1.7（1.2至2.3）。父母死于CVD与类风湿关节炎患者致命性CVD风险增加70%相关（SMR比值 = 1.7（1.2至2.4）），并且在50至67岁的男性中，CVD的10年死亡率从5%增加到10%，女性从2%增加到4%。