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巨细胞动脉炎患者的静脉血栓栓塞和脑血管事件:一项基于人群的回顾性队列研究

Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study.

作者信息

Lo Gullo Alberto, Koster Matthew J, Crowson Cynthia S, Makol Ashima, Ytterberg Steven R, Saitta Antonino, Salvarani Carlo, Matteson Eric L, Warrington Kenneth J

机构信息

Department of Clinical and Experimental Medicine, University of Messina, Messina ME, Italy.

Department of Medicine, Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America.

出版信息

PLoS One. 2016 Feb 22;11(2):e0149579. doi: 10.1371/journal.pone.0149579. eCollection 2016.

Abstract

OBJECTIVE

To investigate the incidence of venous thromboembolism (VTE) and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA) compared to the general population.

METHODS

A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review.

RESULTS

The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women) and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (%) of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014) but similar rates of stroke, transient ischemic attack (TIA), and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events.

CONCLUSION

In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects.

摘要

目的

在一个以社区为基础的巨细胞动脉炎(GCA)患者发病队列中,与普通人群相比,调查静脉血栓栓塞(VTE)和脑血管事件的发生率。

方法

在明尼苏达州奥尔姆斯特德县,收集了1950年1月1日至2009年12月31日期间新发GCA患者的基于人群的起始队列,以及来自同一人群的非GCA受试者队列,并随访至2013年12月31日。通过直接查阅病历确定确诊的VTE和脑血管事件。

结果

研究人群包括244例GCA患者,诊断时的平均年龄±标准差为76.2±8.2岁(79%为女性),平均随访时间为10.2±6.8年。与年龄和性别相似的非GCA受试者相比,诊断为GCA的患者一过性黑矇的发生率(%)更高(累积发生率±标准误:分别为2.1±0.9和0;p = 0.014),但中风、短暂性脑缺血发作(TIA)和VTE的发生率相似。在GCA患者中,诊断时的基线特征和实验室参数均不能可靠地预测VTE或脑血管事件的风险。

结论

在这项基于人群的研究中,GCA患者的VTE、中风和TIA发生率与非GCA受试者相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5128/4763510/b6139433ba6f/pone.0149579.g001.jpg

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