Pugnet Grégory, Sailler Laurent, Fournier Jean-Pascal, Bourrel Robert, Montastruc Jean-Louis, Lapeyre-Mestre Maryse
From the Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université de Toulouse III; INSERM, UMR1027; Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Service Médical Midi-Pyrénées; Service de Pharmacologie Clinique, Centre d'Investigation Clinique (CIC) 1436, and Service de Médecine Interne, Centre Hospitalier Universitaire (CHU) Toulouse, Toulouse, France.
G. Pugnet, MD, PhD, Université de Toulouse III, INSERM, UMR1027, Service de Médecine Interne, CHU Toulouse; L. Sailler, MD, PhD, Université de Toulouse III, INSERM, UMR1027, Service de Médecine Interne, CHU Toulouse; J.P. Fournier, MD, PhD, INSERM, UMR1027, Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université de Toulouse III, Service de Pharmacologie Clinique, CIC 1436, CHU Toulouse; R. Bourrel, MD, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés, Service Médical Midi-Pyrénées; J.L. Montastruc, MD, PhD, INSERM, UMR1027, Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université de Toulouse III, Service de Pharmacologie Clinique, CIC 1436, CHU Toulouse; M. Lapeyre-Mestre, MD, PhD, INSERM, UMR1027, Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université de Toulouse III, Service de Pharmacologie Clinique, CIC 1436, CHU Toulouse.
J Rheumatol. 2016 Dec;43(12):2162-2170. doi: 10.3899/jrheum.151500. Epub 2016 Sep 1.
To identify predictors and protectors for cardiovascular hospitalization in a giant cell arteritis (GCA) population-based cohort.
Using the French National Health Insurance system, we included patients with incident GCA from the Midi-Pyrenees region, southern France, from January 2005 to December 2008 and randomly selected 6 controls matched by sex and age at calendar date. We used a Cox model to identify independent predictors for cardiovascular hospitalization [combining stroke, coronary artery disease (CAD), heart failure, peripheral arterial disease, or cardiac arrhythmias].
Among 103 patients with GCA followed 48.9 ± 14.8 months, the incidence rates of hospitalization for cardiovascular disease, atherosclerotic disease (combining stroke, CAD, and peripheral arterial disease), heart failure, and cardiac arrhythmias were 48.6, 17.5, 14.8, and 9.8 events per 1000 person-years versus 14.9, 4.6, 6.2, and 2.5 events per 1000 person-years among controls, respectively. In patients with GCA, cardiovascular comorbidities at diagnosis (HR 6.2, 2.0-19.2), age over 77 years (HR 5.0, 1.40-17.54), as well as the cumulative defined daily dose of statins (HR 0.993, 0.986-0.999) were independent predictors for subsequent cardiovascular hospitalization. None of the 25 patients with GCA who were taking platelet aggregation inhibitors experienced a cardiovascular hospitalization during followup.
Patients with GCA present a high risk of cardiovascular hospitalization after diagnosis. In patients with incident GCA from the Midi-Pyrenees region, southern France, statin therapy was associated with reduced cardiovascular hospitalizations.
在一个基于人群队列的巨细胞动脉炎（GCA）患者群体中确定心血管住院治疗的预测因素和保护因素。
利用法国国家医疗保险系统，我们纳入了2005年1月至2008年12月来自法国南部米迪 - 比利牛斯地区的初发GCA患者，并按日历日期随机选取6名年龄和性别匹配的对照。我们使用Cox模型来确定心血管住院治疗（包括中风、冠状动脉疾病（CAD）、心力衰竭、外周动脉疾病或心律失常）的独立预测因素。
在103例随访48.9±14.8个月的GCA患者中，心血管疾病、动脉粥样硬化疾病（包括中风、CAD和外周动脉疾病）、心力衰竭和心律失常的住院发生率分别为每1000人年48.6、17.5、14.8和9.8次事件，而对照组分别为每1000人年14.9、4.6、6.2和2.5次事件。在GCA患者中，诊断时的心血管合并症（HR 6.2，2.0 - 19.2）、77岁以上年龄（HR 5.0，1.40 - 17.54）以及他汀类药物的累积限定日剂量（HR 0.993，0.986 - 0.999）是随后心血管住院治疗的独立预测因素。在25例服用血小板聚集抑制剂的GCA患者中，随访期间均未发生心血管住院治疗。
GCA患者诊断后心血管住院风险较高。在法国南部米迪 - 比利牛斯地区的初发GCA患者中，他汀类药物治疗与心血管住院率降低相关。
