Iacono Daniela, Fasano Serena, Pantano Ilenia, D'Abrosca Virginia, Ruscitti Piero, Margiotta Domenico Paolo Emanuele, Navarini Luca, Maruotti Nicola, Grembiale Rosa Daniela, Cantatore Francesco Paolo, Afeltra Antonella, Giacomelli Roberto, Valentini Gabriele
Rheumatology Section, University of Campania "Luigi Vanvitelli", Naples, Italy.
Division of Rheumatology, University of L'Aquila, L'Aquila, Italy.
Cardiol Res Pract. 2019 May 2;2019:2748035. doi: 10.1155/2019/2748035. eCollection 2019.
To investigate the role of acetylsalicylic acid (ASA) in reducing the incidence of cardiovascular (CV) events in an Italian multicentre rheumatoid arthritis (RA) inception cohort.
The clinical charts of RA patients consecutively admitted to 4 Italian centres for their 1 visit from November 1, 2000, to December 31, 2015, and followed up till December 2016 were retrospectively investigated for the incidence of CV events. Patients were subdivided into two groups, namely, ASA- and non-ASA-treated groups. The Kaplan-Meier curve and log-rank test were used to investigate differences in event-free survival. Cox regression analysis was carried out to identify factors associated with CV event occurrence.
Seven hundred forty-six consecutive RA patients were enrolled and followed up for a median of 5.6 years (range 2.9-8.9 years). The incidence rate (IR) of CV events was 8/1000 person-years (p-ys) in the overall cohort. The IR of CV events was significantly lower in the ASA-treated group with respect to the non-ASA-treated group (IR 1.7 vs. 11.8/1000 p-ys; =0.0002). The CV event-free rate was longer in ASA-treated patients than in non-ASA-treated patients (log-rank test 12.8; =0.0003). At multivariable analysis, arterial hypertension (HR 9.3) and hypercholesterolemia (HR 2.8) resulted to be positive predictors and ASA (HR 0.09) and hydroxychloroquine (HCQ) (HR 0.22) to be negative predictors.
The IR of CV events in our Italian multicentre cohort was lower than that reported in other European and non-European cohorts. Low-dose ASA may have a role in the primary prophylaxis of CV events in RA patients.
探讨乙酰水杨酸（ASA）在降低意大利多中心类风湿关节炎（RA）起始队列中心血管（CV）事件发生率方面的作用。
回顾性调查2000年11月1日至2015年12月31日期间连续入住4个意大利中心进行首次就诊并随访至2016年12月的RA患者的临床病历，以了解CV事件的发生率。患者分为两组，即ASA治疗组和非ASA治疗组。采用Kaplan-Meier曲线和对数秩检验来研究无事件生存期的差异。进行Cox回归分析以确定与CV事件发生相关的因素。
连续纳入746例RA患者，中位随访时间为5.6年（范围2.9 - 8.9年）。整个队列中CV事件的发生率为8/1000人年（p-ys）。ASA治疗组的CV事件发生率显著低于非ASA治疗组（发生率1.7 vs. 11.8/1000 p-ys；P = 0.0002）。ASA治疗患者的无CV事件率比非ASA治疗患者更长（对数秩检验12.8；P = 0.0003）。在多变量分析中，动脉高血压（HR 9.3）和高胆固醇血症（HR 2.8）是阳性预测因素，而ASA（HR 0.09）和羟氯喹（HCQ）（HR 0.22）是阴性预测因素。
我们意大利多中心队列中CV事件的发生率低于其他欧洲和非欧洲队列报道的发生率。低剂量ASA可能在RA患者CV事件的一级预防中发挥作用。
