银屑病关节炎患者的心血管风险标志物与主要不良心血管事件
Cardiovascular Risk Markers and Major Adverse Cardiovascular Events in Psoriatic Arthritis Patients.
作者信息
Peluso Rosario, Caso Francesco, Tasso Marco, Ambrosino Pasquale, Dario Di Minno Matteo Nicola, Lupoli Roberta, Criscuolo Livio, Caso Paolo, Ursini Francesco, Puente Antonio Del, Scarpa Raffaele, Costa On Behalf Of CaRRDs Study Group Luisa
机构信息
Department of Clinical Medicine and Surgery - Rheumatology Research Unit - Federico II University, Naples, Italy.
Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
出版信息
Rev Recent Clin Trials. 2018;13(3):199-209. doi: 10.2174/1574887113666180314105511.
BACKGROUND
Psoriatic arthritis is a chronic inflammatory arthropathy that affects 14%- 30% of patients with skin and/or nail psoriasis, leading to severe physical limitations and disability. It has been included in the group of spondyloarthropathy with which it shares clinical, radiologic, and serologic features in addition to familial and genetic relationship. Beyond skin and joint involvement, psoriatic arthritis is characterized by a high prevalence of extra-articular manifestation and comorbidities, such as autoimmune, infectious and neoplastic diseases. In particular, an increased risk of cardiovascular comorbidity has been observed in psoriatic arthritis patients.
METHODS
A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE) up until January 2017. Studies were included if they contained data on CV disease and/or risk factors in PsA and each article was then reviewed for quality and clinical relevance. After completing the literature search all screened literature was summarized and discussed in our study group (CaRDDs study group). All literature and comments were included in the systematic review.
RESULTS
The initial search produced 278 abstracts, which were narrowed to 83 potentially relevant articles by preliminary review of the titles and by excluding review articles and case report (n = 195). Thirty articles were deemed ineligible after examining the abstracts. Full texts of the remaining 53 articles were retrieved. The majority of articles excluded were due to only providing data on patients with psoriasis or due to being not relevant to the CV risk in PsA. In the end, 32 articles were deemed eligible for this review.
CONCLUSION
Psoriatic arthritis appeared significantly associated with subclinical atherosclerosis and endothelial dysfunction and, in turn, with an increased cardiovascular risk. Thus, patients with psoriatic arthritis may benefit from a periodic assessment of surrogate markers of cardiovascular risk. This could help to establish more specific cardiovascular prevention strategies for these patients.
背景
银屑病关节炎是一种慢性炎症性关节病，影响14% - 30%的皮肤和/或指甲银屑病患者，导致严重的身体功能受限和残疾。它已被纳入脊柱关节炎组，除了家族和遗传关系外，还与该组疾病共享临床、放射学和血清学特征。除皮肤和关节受累外，银屑病关节炎的特点是关节外表现和合并症的高患病率，如自身免疫性、感染性和肿瘤性疾病。特别是，在银屑病关节炎患者中观察到心血管合并症的风险增加。
方法
截至2017年1月，在电子数据库（PubMed、科学网、Scopus、EMBASE）中进行了系统检索。如果研究包含银屑病关节炎患者心血管疾病和/或危险因素的数据，则将其纳入，然后对每篇文章进行质量和临床相关性审查。完成文献检索后，所有筛选出的文献在我们的研究组（CaRDDs研究组）中进行总结和讨论。所有文献和评论都纳入了系统评价。
结果
初步检索产生了278篇摘要，通过对标题的初步审查并排除综述文章和病例报告（n = 195），将其缩小到83篇潜在相关文章。在检查摘要后，30篇文章被认为不符合要求。检索到其余53篇文章的全文。大多数被排除的文章是因为仅提供了银屑病患者的数据，或者与银屑病关节炎的心血管风险无关。最终，32篇文章被认为符合本综述的要求。
结论
银屑病关节炎似乎与亚临床动脉粥样硬化和内皮功能障碍显著相关，进而与心血管风险增加相关。因此，银屑病关节炎患者可能受益于定期评估心血管风险的替代标志物。这有助于为这些患者制定更具体的心血管预防策略。
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