Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University , Incheon, Republic of Korea.
Department of Preventive Medicine, College of Medicine, Korea University , Seoul, Republic of Korea.
Scand J Rheumatol. 2020 Jul;49(4):323-331. doi: 10.1080/03009742.2019.1707281. Epub 2020 Apr 14.
Epidemiological studies on inflammatory myopathies (IMs) show widely variable results, and studies on Asians are lacking. Despite emerging interest in the cardiovascular disease (CVD) risk associated with IMs, the prevalence of CVD in IM patients and its impact on mortality remain unclear. We conducted a nationwide, population-based study on the incidence, mortality, and associated major CVD events of IMs in the Republic of Korea over 11 years.
Using the nationwide, population-based National Health Insurance claims database and the Rare Intractable Disease registration programme, we estimated incidence, mortality, and CVD occurrence. Survival was examined using the Kaplan-Meier method. Mortality rate in IMs with CVD was analysed by Cox proportional hazards regression.
There were 3014 incident cases, 640 of whom died during the study period. The mean annual incidence was 7.16/10. Dermatomyositis (DM) and polymyositis (PM) had 5 year survival rates of 76.8% and 79.3%, respectively. Cardiovascular events occurred in 155 patients and 40.6% of IM patients with CVD died. Acute myocardial infarction in men had the highest risk of any CVD event in both DM [standardized incidence ratio (SIR) 4.2, 95% confidence interval (95% CI) 2.4-7.2] and PM (SIR 3.5, 95% CI 1.8-7.0). Haemorrhagic stroke had the highest hazard ratio (HR) in both DM (HR 2.31, 95% CI 1.13-4.70) and PM patients (HR 2.10, 95% CI 1.03-4.27) compared with the general population with CVD.
We found persistently low incidence, poor survival, and high major CVD incidence in IMs, and increased mortality in IMs with CVD.
关于炎性肌病（IMs）的流行病学研究结果差异很大，而亚洲人的研究则很少。尽管人们对 IM 相关的心血管疾病（CVD）风险越来越感兴趣，但 IM 患者 CVD 的患病率及其对死亡率的影响仍不清楚。我们对韩国 11 年来 IM 的发病率、死亡率和相关主要 CVD 事件进行了一项全国性的基于人群的研究。
我们利用全国性的基于人群的国家健康保险索赔数据库和罕见难治性疾病登记计划，估计了 IM 的发病率、死亡率和 CVD 的发生情况。使用 Kaplan-Meier 方法检查生存情况。通过 Cox 比例风险回归分析 IM 合并 CVD 的死亡率。
共发现 3014 例新发病例，其中 640 例在研究期间死亡。平均年发病率为 7.16/10 万。皮肌炎（DM）和多发性肌炎（PM）的 5 年生存率分别为 76.8%和 79.3%。155 例患者发生心血管事件，40.6%的 IM 合并 CVD 患者死亡。男性急性心肌梗死是 DM [标准化发病比（SIR）为 4.2，95%置信区间（95%CI）为 2.4-7.2]和 PM（SIR 为 3.5，95%CI 为 1.8-7.0）中任何 CVD 事件的风险最高。出血性中风在 DM（HR 2.31，95%CI 1.13-4.70）和 PM 患者（HR 2.10，95%CI 1.03-4.27）中均具有最高的危害比（HR），与 CVD 一般人群相比。
我们发现 IM 的发病率持续较低、生存率较差、主要 CVD 发病率较高，且 IM 合并 CVD 的死亡率增加。
