McFarlane Isabel M, Zhaz Leon Su Yien, Bhamra Manjeet S, Burza Aaliya, Waite Stephen Anthony, Rodriguez Alvarez Milena, Koci Kristaq, Taklalsingh Nicholas, Kaplan Ian, Pathiparampil Joshy, Kabani Naureen, Watler Elsie, Sorrento Cristina S, Frefer Mosab, Vaitkus Vytas, Green Jason, Matthew Keron, Arroyo-Mercado Fray, Lyo Helen, Soliman Faisal, Sanchez Randolph A, Reyes Felix M, Ozeri David J, Dronamraju Veena, Trevisonno Michael, Grant Christon, Clerger Guerrier, Amin Khabbab, Freeman Latoya, Dawkins Makeda, Lopez Diana Lenis, Smerling Jonathan, Gondal Irfan, Dellinger Elaine, Paltoo Karen, Bhat Hina, Kolla Srinivas
Department of Medicine, Division of Rheumatology SUNY Downstate Medical Center/Health + Hospitals Kings County, Brooklyn, NY 11201, USA.
Samaritan Medical Center Department of Rheumatology, Watertown, NY 13601, USA.
Med Sci (Basel). 2019 Feb 20;7(2):31. doi: 10.3390/medsci7020031.
Rheumatoid arthritis (RA) patients have nearly twice the risk of cardiovascular disease (CVD) compared to the general population. We aimed to assess, in a predominantly Black population, the prevalence of traditional and RA-specific CVD risk factors and therapeutic patterns. Utilizing ICD codes, we identified 503 RA patients ≥18 years old who were seen from 2010 to 2017. Of them, 88.5% were Black, 87.9% were women and 29.4% were smokers. CVD risk factors (obesity, diabetes, hypertension, dyslipidemia) were higher than in previously reported White RA cohorts. Eighty-seven percent of the patients had at least one traditional CVD risk factor, 37% had three or more traditional CVD risk factors and 58% had RA-specific risk factors (seropositive RA, >10 years of disease, joint erosions, elevated inflammatory markers, extra-articular disease, body mass index (BMI) < 20). CV outcomes (coronary artery disease/myocardial infarction, heart failure, atrial fibrillation and stroke) were comparable to published reports. Higher steroid use, which increases CVD risk, and lesser utilization of biologics (decrease CV risk) were also observed. Our Black RA cohort had higher rates of traditional CVD risk factors, in addition to chronic inflammation from aggressive RA, which places our patients at a higher risk for CVD outcomes, calling for revised risk stratification strategies and effective interventions to address comorbidities in this vulnerable population.
与普通人群相比，类风湿性关节炎（RA）患者患心血管疾病（CVD）的风险几乎高出一倍。我们旨在评估在以黑人为主的人群中，传统和RA特异性CVD风险因素的患病率以及治疗模式。利用国际疾病分类代码，我们确定了2010年至2017年期间就诊的503名年龄≥18岁的RA患者。其中，88.5%为黑人，87.9%为女性，29.4%为吸烟者。CVD风险因素（肥胖、糖尿病、高血压、血脂异常）高于先前报道的白人RA队列。87%的患者至少有一项传统CVD风险因素，37%的患者有三项或更多传统CVD风险因素，58%的患者有RA特异性风险因素（血清阳性RA、病程>10年、关节侵蚀、炎症标志物升高、关节外疾病、体重指数（BMI）<20）。心血管结局（冠状动脉疾病/心肌梗死、心力衰竭、心房颤动和中风）与已发表的报告相当。还观察到增加CVD风险的类固醇使用频率较高，而降低心血管风险的生物制剂使用较少。我们的黑人RA队列除了存在侵袭性RA引起的慢性炎症外，传统CVD风险因素的发生率也较高，这使我们的患者发生CVD结局的风险更高，因此需要修订风险分层策略并采取有效的干预措施来解决这一弱势群体中的合并症。
