Dagan Amir, Mahroum Naim, Segal Gad, Tiosano Shmuel, Watad Abdulla, Comaneshter Doron, Cohen Arnon D, Amital Howard
Department of Medicine 'T', Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2017 Jul;19(7):411-414.
Patients with giant cell arteritis (GCA) suffer from inflammatory diseases often treated by large amounts of corticosteroids. Whether this inflammatory burden also carries an increased risk for cardiovascular morbidity, and especially ischemic heart disease, is not clearly established.
To clarify the linkage between GCA and ischemic heart disease.
In a cross-sectional study, we assessed the association between GCA and ischemic heart disease, adjusting for cardiovascular risk factors, among GCA patients and matched controls using the database of the largest healthcare provider in Israel.
The study group was comprised of 5659 GCA patients and 28,261 age and gender matched controls. The proportion of ischemic heart disease was higher in the GCA group (27.5% vs. 12.5% among controls, odds ratio 2.65). Diabetes mellitus, hypertension, hyperlipidemia and smoking were also found to have higher concurrency in GCA. After stratifying for those cardiovascular co-morbidities using logistic regression, GCA remained independently associated with ischemic heart disease with an odds ratio of 1.247 (1.146-1.357 P < 0.001).
GCA is associated with both cardiovascular risk factors and ischemic heart disease. Healthcare professionals should not overlook this aspect of the disease when managing GCA patients.
巨细胞动脉炎(GCA)患者患有炎症性疾病,常需大量使用皮质类固醇进行治疗。这种炎症负担是否也会增加心血管疾病,尤其是缺血性心脏病的发病风险,目前尚不清楚。
阐明GCA与缺血性心脏病之间的联系。
在一项横断面研究中,我们利用以色列最大医疗服务提供商的数据库,评估了GCA患者及其匹配对照中GCA与缺血性心脏病之间的关联,并对心血管危险因素进行了校正。
研究组包括5659例GCA患者和28261例年龄及性别匹配的对照。GCA组缺血性心脏病的比例更高(对照组为12.5%,GCA组为27.5%,比值比为2.65)。糖尿病、高血压、高脂血症和吸烟在GCA患者中并发率也更高。在使用逻辑回归对这些心血管合并症进行分层后,GCA与缺血性心脏病仍独立相关,比值比为1.247(1.146 - 1.357,P < 0.001)。
GCA与心血管危险因素及缺血性心脏病均有关联。医疗专业人员在管理GCA患者时不应忽视该疾病的这一方面。