Centre for Rheumatic Diseases, Tampere University Hospital, Elämänaukio 2, 33521 Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland.
Institute for Molecular Medicine Finland, FIMM, HiLIFE, University of Helsinki, Tukholmankatu 8, 00290 Helsinki, Finland; Broad Institute of MIT and Harvard, 415 Main St, Cambridge, MA 02142, USA.
Semin Arthritis Rheum. 2024 Apr;65:152382. doi: 10.1016/j.semarthrit.2024.152382. Epub 2024 Jan 26.
To elucidate the risk and temporal relationship of cardiovascular (CV) comorbidities in rheumatic diseases.
Patients in the FinnGen study diagnosed between 2000 and 2014 with seropositive (n = 2368) or seronegative (n = 916) rheumatoid arthritis (RA), ankylosing spondylitis (AS, n = 715), psoriatic arthritis (PsA, n = 923), systemic lupus erythematosus (SLE, n = 190), primary Sjogren's syndrome (pSS, n = 412) or gout (n = 2034) were identified from healthcare registries. Each patient was matched based on age, sex, and birth region with twenty controls without any rheumatic conditions. Overall risk ratios (RR) were calculated by comparing the prevalence of seven CV diseases between patients and controls. Logistic regression models were used for estimating odds ratios (OR) for CV comorbidities before and after the onset of rheumatic diseases.
The RR for 'any CVD' varied from 1.14 (95 % confidence interval [CI] 1.02-1.26) in PsA to 2.05 (95 % CI 1.67-2.52) in SLE. Patients with SLE or gout demonstrated over two-fold risks for several CV comorbidities. Among CV comorbidities, venous thromboembolism (VTE) showed the highest effect sizes in several rheumatic diseases. The ORs for CV comorbidities were highest within one year before and/or after the onset of the rheumatic disease. However, in gout the excess risk of CV disease was especially high before gout diagnosis.
The risk of CV comorbidities was elevated in all studied rheumatic diseases, with highest risks observed in SLE and gout. The risk for CV diseases was highest immediately before and/or after rheumatic disease diagnosis, highlighting the increased risk for CV comorbidities across all rheumatic diseases very early on the disease course.
阐明风湿性疾病中心血管（CV）合并症的风险和时间关系。
从医疗记录中确定了 FinnGen 研究中在 2000 年至 2014 年间诊断为血清阳性（n = 2368）或血清阴性（n = 916）类风湿关节炎（RA）、强直性脊柱炎（AS，n = 715）、银屑病关节炎（PsA，n = 923）、系统性红斑狼疮（SLE，n = 190）、原发性干燥综合征（pSS，n = 412）或痛风（n = 2034）的患者。根据年龄、性别和出生地区，每位患者与二十名无风湿性疾病的对照者相匹配。通过比较患者和对照者七种 CV 疾病的患病率，计算出总体风险比（RR）。使用逻辑回归模型估算风湿性疾病发病前后 CV 合并症的比值比（OR）。
“任何 CVD”的 RR 在 PsA 中为 1.14（95%置信区间 [CI] 1.02-1.26），在 SLE 中为 2.05（95%CI 1.67-2.52）。患有 SLE 或痛风的患者发生几种 CV 合并症的风险增加了两倍以上。在 CV 合并症中，静脉血栓栓塞症（VTE）在几种风湿性疾病中显示出最高的效应大小。风湿性疾病发病前一年及/或发病后一年内，CV 合并症的 OR 最高。然而，在痛风中，痛风诊断前 CV 疾病的风险尤其高。
在所有研究的风湿性疾病中，CV 合并症的风险增加，SLE 和痛风的风险最高。CV 疾病的风险在风湿性疾病诊断前及/或后立即升高，这突显了在疾病过程的早期，所有风湿性疾病的 CV 合并症风险增加。
