强直性脊柱炎患者心血管和脑血管疾病风险增加：一项基于人群的研究。

Increased risk of cardiovascular and cerebrovascular diseases in individuals with ankylosing spondylitis: a population-based study.

作者信息

Szabo Shelagh M, Levy Adrian R, Rao Sumati R, Kirbach Stephanie E, Lacaille Diane, Cifaldi Mary, Maksymowych Walter P

机构信息

Oxford Outcomes, Vancouver, British Columbia, Canada.

出版信息

Arthritis Rheum. 2011 Nov;63(11):3294-304. doi: 10.1002/art.30581.

DOI:10.1002/art.30581

PMID:21834064

Abstract

OBJECTIVE

To estimate the excess risk of cardiovascular and cerebrovascular diseases among individuals with ankylosing spondylitis (AS) in Quebec compared with the general population of Quebec.

METHODS

A retrospective cohort study was conducted using population-based administrative data from Quebec. The cohort included all adult individuals with at least 1 AS diagnosis on physician billing or hospital discharge records between 1996 and 2006. A comparison cohort was generated using a 1% random sample of individuals without AS. Cardiovascular and cerebrovascular diseases, and associated hospitalizations, were classified into 1 of 6 subcategories: congestive heart failure, valvular (aortic or nonaortic) heart disease, ischemic heart disease, cerebrovascular disease, or "other" cardiovascular disease. The age- and sex-stratified prevalence estimates, and standardized prevalence ratios, of cardiovascular or cerebrovascular disease in patients with AS, compared to that in the general population, were calculated.

RESULTS

The AS cohort included 8,616 individuals diagnosed over the period 1996-2006. The prevalence of cardiovascular and cerebrovascular diseases increased with increasing age for all cardiovascular disease subgroups, and was similar for individuals of both sexes. Age- and sex-stratified prevalence ratios were highest in younger individuals with AS. The age- and sex-standardized prevalence ratios comparing the risk among those with AS to the risk in the general population were as follows: for aortic valvular heart disease 1.58 (95% confidence interval [95% CI] 1.31-1.91), for nonaortic valvular heart disease 1.58 (95% CI 1.43-1.74), for ischemic heart disease 1.37 (95% CI 1.31-1.44), for congestive heart failure 1.34 (95% CI 1.26-1.42), for "other" cardiovascular disease 1.36 (95% CI 1.29-1.44), for cerebrovascular disease 1.25 (95% CI 1.15-1.35), and for any hospitalization for a cardiovascular or cerebrovascular disease 1.31 (95% CI 1.22-1.41).

CONCLUSION

Compared with the general population, patients with AS are at increased risk for many types of cardiovascular and cerebrovascular diseases, and are more likely to be hospitalized for these diseases. The excess risk is greatest in younger patients with AS.

摘要

目的

评估魁北克强直性脊柱炎（AS）患者相较于魁北克普通人群发生心血管和脑血管疾病的额外风险。

方法

利用魁北克基于人群的行政数据进行一项回顾性队列研究。该队列包括1996年至2006年间在医生账单或医院出院记录上至少有1次AS诊断的所有成年个体。通过对无AS个体的1%随机样本生成一个对照队列。心血管和脑血管疾病以及相关住院情况被分为6个亚类之一：充血性心力衰竭、瓣膜性（主动脉或非主动脉）心脏病、缺血性心脏病、脑血管疾病或“其他”心血管疾病。计算了AS患者与普通人群相比，心血管或脑血管疾病的年龄和性别分层患病率估计值以及标准化患病率比。

结果

AS队列包括1996 - 2006年期间诊断的8616名个体。所有心血管疾病亚组的心血管和脑血管疾病患病率均随年龄增长而增加，且男女患病率相似。年龄和性别分层的患病率比在年轻的AS个体中最高。将AS患者的风险与普通人群风险进行比较的年龄和性别标准化患病率比如下：主动脉瓣膜性心脏病为1.58（95%置信区间[95%CI]1.31 - 1.91），非主动脉瓣膜性心脏病为1.58（95%CI 1.43 - 1.74），缺血性心脏病为1.37（95%CI 1.31 - 1.44），充血性心力衰竭为1.34（95%CI 1.26 - 1.42），“其他”心血管疾病为1.36（95%CI 1.29 - 1.44），脑血管疾病为1.25（95%CI 1.15 - 1.35），因心血管或脑血管疾病的任何住院情况为1.31（95%CI 1.22 - 1.41）。