Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Autoimmun Rev. 2024 May;23(5):103539. doi: 10.1016/j.autrev.2024.103539. Epub 2024 Apr 4.
Rheumatoid arthritis (RA) is the most common form of autoimmune inflammatory arthritis and is associated with various comorbidities including cardiovascular disease (CVD). This scoping review summarizes the current evidence on longitudinal cohort studies assessing potential factors associated with the incidence of cardiovascular events among patients with RA.
Scopus, PubMed, Ovid MEDLINE and Cochrane databases were used to identify longitudinal cohort studies investigating the incidence of CVD among RA patients. Using predetermined inclusion and exclusion criteria, two reviewers screened and extracted the relevant studies independently to map the existing literature on this topic. The extracted data included study characteristics, demographics, comorbidities, behavioural and RA-related factors.
Thirty-three research papers were included with a mean follow-up duration of 7.8 years. The sample size of the studies ranged from 182 to 4,311,022 subjects, the mean age from 46.1 to 72.3 years, and on average, 34.6% of the participants were male. The following factors were reported to be associated with a higher incidence of CVD in RA patients: older age, male sex, co-morbid hypertension, diabetes, and/or dyslipidemia, the presence of rheumatoid factor (RF) and/or acute phase reactants. Among RA treatments, glucocorticoids were shown to increase CVD incidence while DMARDs, especially methotrexate, were associated with a lower incidence of CVD.
This review offers a comprehensive summary of the current literature reporting on risk factors for CVD incidence among RA patients. Future research should focus on the less studied factors, including socioeconomic status, physical inactivity, alcohol consumption, sleep habits and dietary patterns as well as some RA-related factors such as anti-citrullinated protein antibodies and functional impairment.
类风湿关节炎（RA）是最常见的自身免疫性炎症性关节炎，与各种合并症有关，包括心血管疾病（CVD）。本范围综述总结了目前关于评估 RA 患者心血管事件发生率的潜在因素的纵向队列研究的证据。
使用 Scopus、PubMed、Ovid MEDLINE 和 Cochrane 数据库来确定研究 RA 患者 CVD 发生率的纵向队列研究。使用预定的纳入和排除标准，两名审查员独立筛选和提取相关研究，以绘制关于该主题的现有文献图。提取的数据包括研究特征、人口统计学、合并症、行为和 RA 相关因素。
共纳入 33 篇研究论文，平均随访时间为 7.8 年。研究的样本量范围为 182 至 4311022 例，平均年龄为 46.1 至 72.3 岁，平均 34.6%的参与者为男性。报告以下因素与 RA 患者 CVD 发生率较高相关：年龄较大、男性、合并高血压、糖尿病和/或血脂异常、存在类风湿因子（RF）和/或急性期反应物。在 RA 治疗中，糖皮质激素显示会增加 CVD 的发生率，而 DMARDs，特别是甲氨蝶呤，与 CVD 发生率较低相关。
本综述全面总结了目前关于 RA 患者 CVD 发生率的危险因素的文献报告。未来的研究应关注研究较少的因素，包括社会经济地位、身体活动不足、饮酒、睡眠习惯和饮食模式，以及一些与 RA 相关的因素，如抗瓜氨酸蛋白抗体和功能障碍。
