Gomes Rafael Kmiliauskis Santos, Albers Ana Carolina, Salussoglia Ana Isadora Pianowski, Bazzan Ana Maria, Schreiner Luana Cristina, Vieira Mateus Oliveira, Silva Patrícia Giovana da, Machado Patrícia Helena, Silva Cynthia Mara da, Mattos Mauro Marcelo, Nobre Moacyr Roberto Cuce
Centro de Especialidades dos Municípios de Blumenau e Brusque, Blumenau, SC, Brazil.
Fundação Regional de Blumenau, Faculdade de Medicina, Blumenau, SC, Brazil.
Rev Bras Reumatol Engl Ed. 2017 Sep-Oct;57(5):412-418. doi: 10.1016/j.rbre.2017.01.006. Epub 2017 Feb 8.
To estimate the prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis.
A cross-sectional study using the American College of Rheumatology diagnostic criteria in order to select patients seen at primary or secondary health care units in Blumenau, Santa Catarina, Southern Brazil, in 2014. The presence of ischemic heart disease was defined as an acute myocardial infarction with percutaneous coronary intervention or coronary artery bypass graft surgery that has occurred after diagnosis. Fischer's exact test, Wald's linear trend test, and multivariate logistic regression analysis were used to test the associations.
Among 296 patients (83.1% female) with a mean age of 56.6 years and a mean rheumatoid arthritis duration of 11.3 years, 13 reported having acute myocardial infarction requiring a percutaneous or surgical reperfusion procedure, a prevalence of 4.4% (95% CI 2.0-6.7). Diabetes Mellitus (odds ratio [OR] 4.9 [95% CI 1.6-13.8]) and disease duration >10 years (OR 8.2 [95% CI 1.8-39.7]) were the only factors associated with an ischemic disease that remained in the final model, after the multivariate analysis.
The prevalence of acute myocardial infarction was similar to that observed in other studies. Among the traditional risk factors, Diabetes Mellitus, and among the factors related to rheumatoid arthritis, disease duration, were the variables associated with comorbidity.
评估类风湿关节炎患者缺血性心脏病的患病率及相关因素。
采用美国风湿病学会诊断标准进行横断面研究，以选取2014年在巴西南部圣卡塔琳娜州布卢梅瑙的初级或二级医疗保健单位就诊的患者。缺血性心脏病的存在定义为诊断后发生的经皮冠状动脉介入治疗或冠状动脉搭桥手术的急性心肌梗死。采用费舍尔精确检验、沃尔德线性趋势检验和多因素逻辑回归分析来检验相关性。
在296例患者（女性占83.1%）中，平均年龄为56.6岁，类风湿关节炎平均病程为11.3年，13例报告有需要经皮或手术再灌注治疗的急性心肌梗死，患病率为4.4%（95%可信区间2.0 - 6.7）。多因素分析后，最终模型中与缺血性疾病相关的唯一因素是糖尿病（比值比[OR] 4.9 [95%可信区间1.6 - 13.8]）和病程>10年（OR 8.2 [95%可信区间1.8 - 39.7]）。
急性心肌梗死的患病率与其他研究中观察到的相似。在传统危险因素中，糖尿病以及在与类风湿关节炎相关的因素中，病程是与合并症相关的变量。
