Department of Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong.
Clin Exp Rheumatol. 2012 May-Jun;30(3):345-50. Epub 2012 Jun 25.
To study the predictive value of coronary calcification score (CCS) for future cardiovascular (CVS) events as detected by multi-detector computed tomography (MDCT) in patients with rheumatoid arthritis(RA) and systemic lupus erythematosus (SLE).
A total of 152 patients with RA and SLE, and 106 healthy controls underwent MDCT to measure CCS. All patients were prospectively followed up for major CVS events.
Compared with controls, patients with RA and SLE had a significantly higher mean CCS (42.2±154.3 vs. 1.4±13.0, p<0.01) and prevalence of CCS 1-10, CCS 11-100 and CCS>100 (all p<0.05). After a mean period of 4.3±0.6 years, major CVS events occurred in 10 patients with RA and SLE. In patients with RA and SLE, a higher major CVS events rate occurred in patients with CCS 1-10 (5.0%), CCS 11-100 (14.3%) and CCS >100 (40.0%) than those with CCS=0 (1.0%, p<0.01). Multivariate Cox regression analysis revealed that hypercholesterolemia (hazard ratio (HR) 11.2, confidence interval (CI 1.4-89.3, p=0.02) and CCS>100 (HR 11.1, CI 1.31-95.0, p=0.03) were independent predictors of combined events.
Coronary calcification detected by MDCT independently predicts CVS events in patients with RA and SLE. Risk stratification by assessment of CCS may have an important role in patients with systemic inflammatory disease.
通过多排螺旋 CT（MDCT）检测，研究类风湿关节炎（RA）和系统性红斑狼疮（SLE）患者冠状动脉钙化评分（CCS）对未来心血管（CVS）事件的预测价值。
共 152 例 RA 和 SLE 患者和 106 例健康对照者行 MDCT 测量 CCS。所有患者均前瞻性随访主要 CVS 事件。
与对照组相比，RA 和 SLE 患者的平均 CCS（42.2±154.3 比 1.4±13.0，p<0.01）和 CCS 1-10、CCS 11-100 和 CCS>100 的发生率均显著升高（均 p<0.05）。在平均 4.3±0.6 年后，10 例 RA 和 SLE 患者发生主要 CVS 事件。在 RA 和 SLE 患者中，CCS 1-10（5.0%）、CCS 11-100（14.3%）和 CCS>100（40.0%）患者的主要 CVS 事件发生率高于 CCS=0（1.0%，p<0.01）。多变量 Cox 回归分析显示，高胆固醇血症（危险比（HR）11.2，置信区间（CI）1.4-89.3，p=0.02）和 CCS>100（HR 11.1，CI 1.31-95.0，p=0.03）是复合事件的独立预测因子。
MDCT 检测到的冠状动脉钙化独立预测 RA 和 SLE 患者的 CVS 事件。通过评估 CCS 进行风险分层可能在系统性炎症性疾病患者中具有重要作用。
