Min Hong Ki, Kim Hae-Rim, Lee Sang-Heon, Kang Kwi Young, Park Sung-Hwan, Kwok Seung-Ki
Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, Republic of Korea.
Joint Bone Spine. 2022 Oct;89(5):105401. doi: 10.1016/j.jbspin.2022.105401. Epub 2022 May 2.
To evaluate the predictive role of time-averaged disease activity score (DAS)28 and Health Assessment Questionnaire (HAQ) on cardiovascular disease (CVD) events in patients with rheumatoid arthritis (RA).
Patients with RA were recruited from 23 tertiary hospitals. Baseline and annual follow-up data of demographic, laboratory, questionnaire, RA-associated parameters, and occurrence of CVD were collected. Patients were divided into three groups according to time-averaged DAS28: 1) remission (<2.6), 2) low (2.6-3.2), 3) moderate (3.2-5.1), and 4) high (>5.1). Kaplan-Meier curves was performed to compare the cumulative probability of CVD. Hazard ratios of each factor on the occurrence of CVD were obtained using Cox regression analyses.
A total of 4,034 RA patients with 826 for remission, 938 for low, 2,002 for moderate, and 268 for high time-averaged DAS28 groups were included. Baseline age, disease duration, ESR, CRP, DAS28, and HAQ scores were higher in the high time-averaged DAS28 group. The incidence rate of CVD was 2.86, 2.71, 3.53, and 8.13 events per 1,000 person-years for the remission, low, moderate, and high time-averaged DAS28 groups, respectively. The incidence rate ratio of CVD in the high time-averaged DAS28 group were 3.01 (95% CI 1.20-8.50) when compared to low time-averaged DAS28 group. The cumulative hazard for CVD in the high time-averaged DAS28 group was significantly high (log-rank P<0.01). In multivariate Cox regression analysis, age, high time-averaged DAS28, and time-averaged HAQ>0.5, were positively associated with CVD events in RA patients.
In patients with RA, time-averaged DAS28 and HAQ could predict the occurrence of CVD.
Clinical Research Information Service of South Korea https://cris.nih.go.kr: KCT0000086, registered May 26, 2009.
评估时间平均疾病活动评分（DAS）28和健康评估问卷（HAQ）对类风湿关节炎（RA）患者心血管疾病（CVD）事件的预测作用。
从23家三级医院招募RA患者。收集人口统计学、实验室、问卷、RA相关参数及CVD发生情况的基线和年度随访数据。根据时间平均DAS28将患者分为三组：1）缓解组（<2.6），2）低疾病活动组（2.6 - 3.2），3）中度疾病活动组（3.2 - 5.1），4）高疾病活动组（>5.1）。采用Kaplan-Meier曲线比较CVD的累积概率。使用Cox回归分析获得各因素对CVD发生的风险比。
共纳入4034例RA患者，其中时间平均DAS28缓解组826例，低疾病活动组938例，中度疾病活动组2002例，高疾病活动组268例。高时间平均DAS28组的基线年龄、病程、红细胞沉降率（ESR）、C反应蛋白（CRP）、DAS28和HAQ评分更高。缓解组、低疾病活动组、中度疾病活动组和高疾病活动组的CVD发病率分别为每1000人年2.86、2.71、3.53和8.13例。与低时间平均DAS28组相比，高时间平均DAS28组的CVD发病率比为3.01（95%可信区间1.20 - 8.50）。高时间平均DAS28组的CVD累积风险显著更高（对数秩检验P<0.01）。在多变量Cox回归分析中，年龄、高时间平均DAS28和时间平均HAQ>0.5与RA患者的CVD事件呈正相关。
在RA患者中，时间平均DAS28和HAQ可预测CVD的发生。
韩国临床研究信息服务中心https://cris.nih.go.kr：KCT0000086，2009年5月26日注册。
