骨关节炎患者心血管疾病风险：一项前瞻性纵向研究。

Risk of cardiovascular disease in patients with osteoarthritis: a prospective longitudinal study.

机构信息

University of British Columbia, Vancouver, and Arthritis Research Centre of Canada, Richmond, British Columbia, Canada.

出版信息

Arthritis Care Res (Hoboken). 2013 Dec;65(12):1951-8. doi: 10.1002/acr.22092.

DOI:10.1002/acr.22092

PMID:23925995

Abstract

OBJECTIVE

To determine the risk of cardiovascular disease (CVD) among osteoarthritis (OA) patients using population-based administrative data from British Columbia, Canada.

METHODS

The medical history of a random sample of 600,000 individuals from 1991-2009 was analyzed. A total of 12,745 OA cases and up to 3 non-OA individuals matched by age, sex, and year of diagnosis were followed for CVD events. Cox proportional hazards and Poisson regression models were used to estimate the relative risks (RRs) of CVD, myocardial infarction, ischemic heart disease (IHD), congestive heart failure (CHF), and stroke after adjusting for available sociodemographic and medical factors.

RESULTS

OA was an independent predictor of CVD. The adjusted RRs were 1.15 (95% confidence interval [95% CI] 1.04-1.27), 1.26 (95% CI 1.13-1.42), and 1.17 (95% CI 1.07-1.26) among older men, younger women, and older women, respectively. Analyses were stratified by age and sex due to statistically significant interactions between OA and age and sex. RRs among older men, younger women, and older women were 1.33 (95% CI 1.11-1.62), 1.66 (95% CI 1.37-2.01), and 1.45 (95% CI 1.22-1.72) for IHD, respectively, and 1.25 (95% CI 1.02-1.54), 1.29 (95% CI 1.00-1.68), and 1.20 (95% CI 1.03-1.39) for CHF, respectively. Compared to non-OA individuals, OA cases who underwent total joint replacements had a 26% increased risk of CVD.

CONCLUSION

This prospective longitudinal study suggests that OA is associated with an increased risk of CVD. Older men and adult women with OA had a higher risk of CVD, particularly IHD and CHF. Further studies are needed to confirm these results and to elucidate the potential biologic mechanisms.

摘要

目的

利用加拿大不列颠哥伦比亚省基于人群的行政数据，确定骨关节炎（OA）患者发生心血管疾病（CVD）的风险。

方法

对 1991-2009 年的随机抽取的 600000 人的医疗史进行分析。对总共 12745 例 OA 病例和最多 3 名年龄、性别和诊断年份匹配的非 OA 个体进行 CVD 事件随访。使用 Cox 比例风险和泊松回归模型，在调整了可用的社会人口统计学和医疗因素后，估计 CVD、心肌梗死、缺血性心脏病（IHD）、充血性心力衰竭（CHF）和中风的相对风险（RR）。

结果

OA 是 CVD 的独立预测因子。在年龄较大的男性、年龄较小的女性和年龄较大的女性中，调整后的 RR 分别为 1.15（95%置信区间[95%CI]1.04-1.27）、1.26（95%CI 1.13-1.42）和 1.17（95%CI 1.07-1.26）。由于 OA 与年龄和性别之间存在统计学显著的交互作用，因此按年龄和性别进行了分析。在年龄较大的男性、年龄较小的女性和年龄较大的女性中，IHD 的 RR 分别为 1.33（95%CI 1.11-1.62）、1.66（95%CI 1.37-2.01）和 1.45（95%CI 1.22-1.72），CHF 的 RR 分别为 1.25（95%CI 1.02-1.54）、1.29（95%CI 1.00-1.68）和 1.20（95%CI 1.03-1.39）。与非 OA 个体相比，接受全关节置换术的 OA 病例 CVD 风险增加 26%。