Fernández-Gutiérrez Benjamín, Perrotti Pedro P, Gisbert Javier P, Domènech Eugeni, Fernández-Nebro Antonio, Cañete Juan D, Ferrándiz Carlos, Tornero Jesús, García-Sánchez Valle, Panés Julián, Fonseca Eduardo, Blanco Francisco, Rodríguez-Moreno Jesús, Carreira Patricia, Julià Antonio, Marsal Sara, Rodriguez-Rodriguez Luis
Rheumatology Department and Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid Rheumatology Research Group, Vall d'Hebron Hospital Research Institute Department of Medicine, University of Barcelona, Barcelona Gastroenterology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD) Gastroenterology and Hepatology Department, Hospital Universitari Germans Trias i Pujol, Badalona UGC Reumatología, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga Rheumatology Department, Hospital Clinic and IDIBAPS Dermatology Department, Hospital Universitari Germans Trias i Pujol, Badalona Universidad Autónoma de Barcelona, Barcelona Rheumatology Department, Hospital General Universitario de Guadalajara, Guadalajara Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba Hospital Clínic de Barcelona and IDIBAPS, Barcelona Dermatology Department Rheumatology Department, Complejo Hospitalario Universitario A Coruña, INIBIC, A Coruña Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat Rheumatology Department, Hospital Universitario Doce de Octubre, Madrid, Spain.
Medicine (Baltimore). 2017 Jun;96(26):e7308. doi: 10.1097/MD.0000000000007308.
To analyze in several immune-mediated inflammatory diseases (IMIDs) the influence of demographic and clinical-related variables on the prevalence of cardiovascular disease (CVD), and compare their standardized prevalences.Cross-sectional study, including consecutive patients diagnosed with rheumatoid arthritis, psoriatic arthritis, psoriasis, systemic lupus erythematosus, Crohn disease, or ulcerative colitis, from rheumatology, gastroenterology, and dermatology tertiary care outpatient clinics located throughout Spain, between 2007 and 2010. Our main outcome was defined as previous diagnosis of angina, myocardial infarction, peripheral vascular disease, and/or stroke. Bivariate and multivariate logistic and mixed-effects logistic regression models were performed for each condition and the overall cohort, respectively. Standardized prevalences (in subjects per 100 patients, with 95% confidence intervals) were calculated using marginal analysis.We included 9951 patients. For each IMID, traditional cardiovascular risk factors had a different contribution to CVD. Overall, older age, longer disease duration, presence of traditional cardiovascular risk factors, and male sex were independently associated with a higher CVD prevalence. After adjusting for demographic and traditional cardiovascular risk factors, systemic lupus erythematosus exhibited the highest CVD standardized prevalence, followed by rheumatoid arthritis, psoriasis, Crohn disease, psoriatic arthritis, and ulcerative colitis (4.5 [95% confidence interval (CI): 2.2, 6.8], 1.3 [95% CI: 0.8, 1.8], 0.9 [95% CI: 0.5, 1.2], 0.8 [95% CI: 0.2, 1.3], 0.6 [95% CI: 0.2, 1.0], and 0.5 [95% CI: 0.1, 0.8], respectively).Systemic lupus erythematosus, rheumatoid arthritis, and psoriasis are associated with higher prevalence of CVD compared with other IMIDs. Specific prevention programs should be established in subjects affected with these conditions to prevent CVD.
分析几种免疫介导的炎症性疾病（IMID）中人口统计学和临床相关变量对心血管疾病（CVD）患病率的影响，并比较其标准化患病率。横断面研究，纳入2007年至2010年间来自西班牙各地风湿病、胃肠病学和皮肤病学三级护理门诊连续诊断为类风湿关节炎、银屑病关节炎、银屑病、系统性红斑狼疮、克罗恩病或溃疡性结肠炎的患者。我们的主要结局定义为既往有心绞痛、心肌梗死、外周血管疾病和/或中风的诊断。分别对每种疾病和整个队列进行双变量和多变量逻辑回归及混合效应逻辑回归模型分析。使用边际分析计算标准化患病率（每100例患者中的病例数，95%置信区间）。我们纳入了9951例患者。对于每种IMID，传统心血管危险因素对CVD的影响各不相同。总体而言，年龄较大、病程较长、存在传统心血管危险因素以及男性与较高的CVD患病率独立相关。在调整人口统计学和传统心血管危险因素后，系统性红斑狼疮的CVD标准化患病率最高，其次是类风湿关节炎、银屑病、克罗恩病、银屑病关节炎和溃疡性结肠炎（分别为4.5 [95%置信区间（CI）：2.2，6.8]、1.3 [95% CI：0.8，1.8]、0.9 [95% CI：0.5，1.2]、0.8 [95% CI：0.2，1.3]、0.6 [95% CI：0.2，1.0]和0.5 [95% CI：0.1，0.8]）。与其他IMID相比，系统性红斑狼疮、类风湿关节炎和银屑病与较高的CVD患病率相关。应针对患有这些疾病的患者制定特定的预防方案以预防CVD。
