Correspondence to Jesper Lindhardsen, Department of Cardiology, section PA (Post 67), Gentofte Hospital, Niels Andersensvej 65, DK-2900 Hellerup, Denmark.
Ann Rheum Dis. 2011 Jun;70(6):929-34. doi: 10.1136/ard.2010.143396. Epub 2011 Mar 9.
To examine in a nationwide cohort whether the risk of myocardial infarction (MI) in patients with rheumatoid arthritis (RA) is comparable to the risk in patients with diabetes mellitus (DM).
The study included the entire Danish population followed from 1 January 1997 until 31 December 2006. Through individual level-linkage of nationwide administrative registers, the authors identified subjects who developed RA and DM. The risk of MI was analysed using multivariable Poisson regression models including data on cardioprotective drugs, comorbidity and socioeconomic status.
From a total of 4,311,022 individuals included in the cohort, 10,477 and 130,215 individuals developed RA and DM respectively. The overall incidence rate ratio (IRR) of MI in RA was 1.7 (95% CI 1.5 to 1.9), which was similar to the risk in DM (1.7 (1.6 to 1.8); p=0.64 for difference). The risk was significantly increased in all groups when stratifying on age and gender, with higher RRs in younger patients. This was especially pronounced in women <50 years with RA or DM, who were subject to a sixfold increase in RR. The RA-related risk of MI was unaffected by the duration of pharmacological RA treatment and corresponded to the overall risk of MI observed in non-RA subjects, who were on the average 10 years older.
RA is associated with the same risk of MI as DM, and the risk of MI in RA patients generally corresponded to the risk in non-RA subjects 10 years older.
在全国范围内的队列中研究类风湿关节炎（RA）患者发生心肌梗死（MI）的风险是否与糖尿病（DM）患者的风险相当。
这项研究纳入了 1997 年 1 月 1 日至 2006 年 12 月 31 日期间丹麦的所有人群。通过个体水平的全国性行政登记数据链接，研究人员确定了发生 RA 和 DM 的患者。使用多变量泊松回归模型分析 MI 的风险，模型中包含了有关心脏保护药物、合并症和社会经济状况的数据。
在纳入的队列中的 4311022 名个体中，分别有 10477 人和 130215 人患有 RA 和 DM。RA 患者发生 MI 的总体发病率比值（IRR）为 1.7（95%CI 1.5 至 1.9），与 DM 的风险（1.7（1.6 至 1.8））相似（差异的 p 值=0.64）。在按年龄和性别分层时，所有组的风险均显著增加，年轻患者的 RR 更高。在 RA 或 DM 患者中，年龄<50 岁的女性尤其明显，RR 增加了六倍。RA 相关的 MI 风险不受 RA 药物治疗持续时间的影响，与非 RA 患者观察到的总体 MI 风险相对应，后者的平均年龄大 10 岁。
RA 发生 MI 的风险与 DM 相当，RA 患者发生 MI 的风险一般与大 10 岁的非 RA 患者的风险相对应。
