Division of Rheumatology, Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Marmara University, İstanbul, Türkiye.
Division of Rheumatology, Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Ankara University, Ankara, Türkiye.
Rheumatol Int. 2024 Feb;44(2):291-301. doi: 10.1007/s00296-023-05515-y. Epub 2023 Dec 29.
Patients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular (CV) comorbidities. The association of CV diseases (CVD) and traditional CV risk factors has been debated, depending on patient and RA characteristics. This study aimed to find the prevalence of CVD and CV risk factors in patients with RA. A multi-center cross-sectional study was performed on RA patients using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) in September 2022. Socio-demographic, clinical, and follow-up data were collected. Myocardial infarction, ischemic heart disease, peripheral vascular disorders, congestive heart failure, ischemic stroke, and transient ischemic attack were regarded as major adverse cardiovascular events (MACEs). CVD was defined as the presence of at least one clinical situation of MACE. Group 1 and Group 2 included patients with and without CVD. Prevalence rates of CVD and traditional CV risk factors were the primary outcomes. Secondary outcomes were the differences in the clinical characteristics between patients with and without CVD. An analysis of 724 patients with a mean age of 55.1 ± 12.8 years diagnosed with RA was conducted. There was a female preponderance (79.6%). The prevalence rate of CVD was 4.6% (n = 33). The frequencies of the diseases in the MACE category were ischemic heart disease in 27, congestive heart failure in five, peripheral vascular disorders in three, and cerebrovascular events in three patients. The patients with CVD (Group 1) were significantly male, older, and had higher BMI (p = 0.027, p < 0.001, and p = 0.041). Obesity (33.4%) and hypertension (27.2%) were the two CV risk factors most frequently. Male sex (HR = 7.818, 95% CI 3.030-20.173, p < 0.001) and hypertension (HR = 4.570, 95% CI 1.567-13.328, p = 0.005) were the independent risk factors for CVD. The prevalence of CVD in RA patients was 4.6%. Some common risk factors for CVD in the general population, including male sex, older age, and hypertension, were evident in RA patients. Male sex and hypertension were the independent risk factors for developing CVD in patients with RA.
类风湿关节炎（RA）患者由于心血管（CV）合并症而导致发病率和死亡率增加。CV 疾病（CVD）与传统 CV 危险因素之间的关联一直存在争议，具体取决于患者和 RA 的特征。本研究旨在探讨 RA 患者 CVD 和 CV 危险因素的患病率。2022 年 9 月，使用 BioSTAR（生物和靶向合成疾病修饰抗风湿药物登记处）对 RA 患者进行了一项多中心横断面研究。收集了社会人口统计学、临床和随访数据。心肌梗死、缺血性心脏病、外周血管疾病、充血性心力衰竭、缺血性中风和短暂性脑缺血发作被视为主要不良心血管事件（MACEs）。CVD 定义为至少存在一种 MACE 临床情况。第 1 组和第 2 组包括有和没有 CVD 的患者。CVD 和传统 CV 危险因素的患病率是主要结局。次要结局是有和没有 CVD 的患者之间临床特征的差异。对 724 名平均年龄为 55.1±12.8 岁的 RA 患者进行了分析。女性占优势（79.6%）。CVD 的患病率为 4.6%（n=33）。MACE 类别中的疾病频率分别为 27 例缺血性心脏病、5 例充血性心力衰竭、3 例外周血管疾病和 3 例脑血管事件。CVD 患者（第 1 组）的男性明显较多，年龄较大，BMI 较高（p=0.027，p<0.001 和 p=0.041）。肥胖（33.4%）和高血压（27.2%）是最常见的两种 CV 危险因素。男性（HR=7.818，95%CI 3.030-20.173，p<0.001）和高血压（HR=4.570，95%CI 1.567-13.328，p=0.005）是 CVD 的独立危险因素。RA 患者 CVD 的患病率为 4.6%。一些普通人群 CVD 的常见危险因素，包括男性、年龄较大和高血压，在 RA 患者中也很明显。男性和高血压是 RA 患者发生 CVD 的独立危险因素。
