在银屑病关节炎患者中寻找心血管风险因素和疾病：来自北特伦德拉格健康研究的基于人群的数据。
On the HUNT for cardiovascular risk factors and disease in patients with psoriatic arthritis: population-based data from the Nord-Trøndelag Health Study.
机构信息
Department of Rheumatology, St. Olavs Hospital, Trondheim, Norway Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
出版信息
Ann Rheum Dis. 2016 May;75(5):819-24. doi: 10.1136/annrheumdis-2014-206824. Epub 2015 Mar 26.
OBJECTIVE
To compare the presence of cardiovascular (CV) risk factors and established CV disease in patients with psoriatic arthritis (PsA) and the general population and to compare the 10-year risk of a fatal CV event calculated by the Systematic Coronary Risk Evaluation (SCORE) algorithm.
METHODS
Patients with PsA (n=338) and controls (n=50 468) were recruited from the Nord-Trøndelag Health Study 3. Age-adjusted and sex-adjusted prevalence rates of CV risk factors and comorbidity were calculated and the SCORE algorithm was applied.
RESULTS
There was an increased prevalence of angina pectoris (5.0% vs 3.6%, p=0.01), history of percutaneous coronary intervention (2.4% vs 1.4%, p=0.04), hypertension (45.3% vs 39.3%, p=0.01), obesity (32.0% vs 22.4%) and tobacco smoking (21.3% vs 16.4%, p=0.02) in patients with PsA compared with controls. Patients with PsA had elevated levels of C reactive protein (CRP; p<0.001), body mass index (BMI; p<0.001) and triglycerides (p=0.01). The median calculated CV risk in patients with PsA was low and comparable with controls (0.87 vs 0.83, p=0.24). The distribution across CV risk classes was similar among patients with PsA and controls.
CONCLUSIONS
Patients with PsA have a higher risk of CV disease than the background population, although there was no difference between groups in 10-year risk of a fatal CV event estimated by SCORE. However, patients with PsA had elevated levels of CV risk factors not included in the SCORE algorithm, such as BMI, triglycerides and CRP.
目的
比较银屑病关节炎（PsA）患者与普通人群中心血管（CV）危险因素和已确诊 CV 疾病的存在情况，并比较应用系统性冠状动脉风险评估（SCORE）算法计算的 10 年致命 CV 事件风险。
方法
从北特伦德拉格健康研究 3 中招募了 338 名 PsA 患者和 50468 名对照者。计算了 CV 危险因素和合并症的年龄调整和性别调整患病率，并应用了 SCORE 算法。
结果
与对照组相比，PsA 患者心绞痛（5.0% vs. 3.6%，p=0.01）、经皮冠状动脉介入治疗史（2.4% vs. 1.4%，p=0.04）、高血压（45.3% vs. 39.3%，p=0.01）、肥胖症（32.0% vs. 22.4%）和吸烟（21.3% vs. 16.4%，p=0.02）的患病率更高。与对照组相比，PsA 患者 C 反应蛋白（CRP；p<0.001）、体重指数（BMI；p<0.001）和甘油三酯（p=0.01）水平升高。PsA 患者计算出的 CV 风险中位数较低，与对照组相当（0.87 vs. 0.83，p=0.24）。PsA 患者和对照组的 CV 风险类别分布相似。
结论
与普通人群相比，PsA 患者患 CV 疾病的风险更高，尽管 SCORE 估计的致命 CV 事件 10 年风险在两组之间无差异。然而，PsA 患者存在 SCORE 算法中未包含的 CV 危险因素，如 BMI、甘油三酯和 CRP，水平升高。
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