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类风湿关节炎中心血管疾病风险预测评分与血管功能及形态的关系

The relationship between cardiovascular disease risk prediction scores and vascular function and morphology in rheumatoid arthritis.

作者信息

Sandoo Aamer, Chanchlani Neil, Hodson James, Smith Jacqueline P, Douglas Karen M, Kitas George D

机构信息

Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, UK.

出版信息

Clin Exp Rheumatol. 2014 Nov-Dec;32(6):914-21. Epub 2014 Aug 15.

Abstract

OBJECTIVES

Patients with rheumatoid arthritis (RA) are at an increased risk for cardiovascular disease (CVD) resulting from impairments in vascular function and morphology. CVD risk prediction scores can identify patients at high risk of CVD, but little is known about whether they relate with assessments of vascular function and morphology which provide early indication of subclinical atherosclerosis. The objective of the present study was to examine the relationship of several CVD risk prediction scores with assessments of vascular function and morphology in patients with RA.

METHODS

Framingham risk score, Systematic Coronary Risk Evaluation for total cholesterol and ratio of total cholesterol to high-density lipoprotein, as well as Reynolds Risk Score, and QRISK2 were calculated in 201 RA patients (155 females, median (25th to 75th percentile) age: 61 (53-67)) who were examined at baseline (2006). The European League Against Rheumatism (EULAR) multiplication factor was also applied to the algorithms. At a 6-year follow-up (2012) visit the patients underwent assessments of microvascular and macrovascular endothelium-dependent and endothelium-independent function, along with assessment of carotid atherosclerosis.

RESULTS

All five CVD risk prediction scores measured at baseline were significantly correlated with vascular function and morphology at follow-up. Application of the EULAR multiplication factor did not change any of the associations.

CONCLUSIONS

Five commonly used CVD risk prediction scores associate with assessments of vascular function and morphology over a 6-year follow-up period suggesting that these CVD risk prediction scores may also reflect subclinical atherosclerotic changes.

摘要

目的

类风湿关节炎(RA)患者因血管功能和形态受损,患心血管疾病(CVD)的风险增加。CVD风险预测评分可识别CVD高危患者,但对于它们是否与血管功能和形态评估相关尚知之甚少,而血管功能和形态评估可为亚临床动脉粥样硬化提供早期迹象。本研究的目的是检验几种CVD风险预测评分与RA患者血管功能和形态评估之间的关系。

方法

对201例RA患者(155例女性,年龄中位数(第25至75百分位数):61(53 - 67)岁)在基线期(2006年)进行检查,并计算其弗明汉风险评分、总胆固醇及总胆固醇与高密度脂蛋白比值的系统性冠状动脉风险评估、雷诺兹风险评分以及QRISK2。欧洲抗风湿病联盟(EULAR)倍增因子也应用于这些算法。在6年随访期(2012年)访视时,对患者进行微血管和大血管内皮依赖性及非内皮依赖性功能评估,以及颈动脉粥样硬化评估。

结果

基线时测量的所有五种CVD风险预测评分均与随访时的血管功能和形态显著相关。应用EULAR倍增因子并未改变任何关联。

结论

在6年随访期内,五种常用的CVD风险预测评分与血管功能和形态评估相关,这表明这些CVD风险预测评分可能也反映了亚临床动脉粥样硬化变化。

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