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高安动脉炎与缺血性心脏病之间的关联:一项队列研究。

Association between Takayasu arteritis and ischemic heart disease: a cohort study.

作者信息

Versini Mathilde, Tiosano Shmuel, Sharif Kassem, Mahroum Naim, Watad Abdulla, Comaneshter Doron, Shalom Guy, Shoenfeld Yehuda, Cohen Arnon D, Amital Howard

机构信息

Department of Internal Medicine, Archet-1 Hospital, University of Nice-Sophia-Antipolis, Nice, France.

Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Israel.

出版信息

Mediterr J Rheumatol. 2019 Sep 30;30(3):171-176. doi: 10.31138/mjr.30.3.171. eCollection 2019 Sep.

Abstract

PURPOSE OF THE STUDY

Takayasu arteritis (TA) is an idiopathic large vessel vasculitis, which involves the aorta and its major branches. Our aim was to examine the association between TA and the development of ischemic heart disease (IHD) and its impact on survival.

STUDY DESIGN

Using data from Clalit Health Services (CHS), the largest Health Maintenance Organization (HMO) in Israel, the proportion of IHD was compared between patients diagnosed with TA and age- and gender-matched controls. Chi-square and t-tests were used for univariate analysis, and a logistic regression model was employed for multivariate analysis. Survival analysis was performed using Kaplan-Meier plots and cox regression.

RESULTS

The study included 155 TA patients and 755 age- and gender-frequency matched controls. The proportion of IHD in TA patients was increased in comparison with controls (32.3% and 8.9%, p<0.001). In multivariate analysis, IHD was associated with TA (OR=6.576, 95% CI: 4.09-10.64) and male gender (OR=2.29, 95% CI: 1.43-4.26). Survival analysis over 15 years of follow-up showed a higher proportion of all-causes mortality in the TA group. In a multivariate analysis, TA (HR=2.58, 95%CI: 1.64-4.06) and IHD (HR=1.64, 95%CI: 1.05-2.55) were found to be associated with reduced survival.

CONCLUSIONS

TA patients present an increased proportion of IHD, and a reduced 15-years survival rate compared to controls.

摘要

研究目的

高安动脉炎(TA)是一种特发性大血管血管炎,累及主动脉及其主要分支。我们的目的是研究TA与缺血性心脏病(IHD)发生之间的关联及其对生存的影响。

研究设计

利用以色列最大的健康维护组织(HMO)——克拉利特健康服务机构(CHS)的数据,比较诊断为TA的患者与年龄和性别匹配的对照组中IHD的比例。采用卡方检验和t检验进行单因素分析,采用逻辑回归模型进行多因素分析。使用Kaplan-Meier曲线和Cox回归进行生存分析。

结果

该研究纳入了155例TA患者和755例年龄和性别频率匹配的对照组。与对照组相比,TA患者中IHD的比例更高(分别为32.3%和8.9%,p<0.001)。在多因素分析中,IHD与TA(OR=6.576,95%CI:4.09-10.64)和男性性别(OR=2.29,95%CI:1.43-4.26)相关。15年随访的生存分析显示,TA组全因死亡率的比例更高。在多因素分析中,发现TA(HR=2.58,95%CI:1.64-4.06)和IHD(HR=1.64,95%CI:1.05-2.55)与生存率降低相关。

结论

与对照组相比,TA患者中IHD的比例增加,15年生存率降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb6a/7045855/c7571c163342/MJR-30-3-171-g001.jpg

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