抗 Ro 和抗 La 抗体阳性与成年人缺血性心脏病发生率增加相关：一项大型基于人群的研究结果。

Anti-Ro and anti-La seropositivity is associated with increased rates of ischemic heart disease in adults: Results from a large population-based study.

机构信息

Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine, Tel-Aviv University, Israel.

Department of Geriatric Medicine C, Sheba Medical Center, Tel Hashomer, Israel.

出版信息

Atherosclerosis. 2024 Sep;396:117626. doi: 10.1016/j.atherosclerosis.2024.117626. Epub 2024 Jun 15.

DOI:10.1016/j.atherosclerosis.2024.117626

PMID:39002391

Abstract

BACKGROUND AND AIMS

Emerging evidence suggests an arrhythmogenic effect of Anti-Ro/SSA (anti-Ro) and anti-La/SSB (anti-La) antibodies in adults, potentially involving a subclinical intracardiac inflammatory process. Despite the established association between inflammation and ischemic heart disease (IHD), it is noteworthy that as of now no study has delved into the potential link between these antibodies and IHD. This population-based study aimed to examine the association between anti-Ro/La seropositivity and IHD in the general adult population.

METHODS

We conducted a retrospective study using electronic medical records from the largest health maintenance organization in Israel. Patients with positive serology for either or both anti-Ro and anti-La antibodies were included, along with matched controls. Multivariate logistic regression models were utilized to assess the odds of IHD in seropositive patients compared to controls.

RESULTS

Among 17,231 seropositive patients and 84,368 controls, the rate of IHD was significantly higher in the seropositive group (9.7 % vs. 8.1 %,OR = 1.23; 95%CI 1.14-1.31; p<0.001). The association was more pronounced in younger patients [<40 years old (OR = 3.36; 95%CI 1.66-6.82; p<0.001), 40-49 years old (OR = 1.85; 95%CI 1.26-2.73; p<0.01), 50-59 years old (OR = 1.87; 95%CI 1.55-2.26; p<0.001), 60-69 years old (OR = 1.26; 95%CI 1.11-1.42; p<0.001), ≥70 years old (OR = 1.11; 95%CI 1.03-1.20; p<0.01)], as well as in patients with fewer traditional cardiovascular risk-factors (none:OR = 1.29; 95 % CI 1.09 to 1.77; p<0.01, 1-2:OR = 1.30; 95 % CI 1.19 to 1.41; p<0.001, ≥3:OR = 1.09; 95 % CI 0.99 to 1.21; p=0.076).

CONCLUSIONS

Our study demonstrates for the first time a positive association between anti-Ro/La seropositivity and IHD in the general adult population, especially among younger individuals with fewer traditional cardiovascular risk factors.

摘要

背景与目的

越来越多的证据表明，抗 Ro/SSA（抗 Ro）和抗 La/SSB（抗 La）抗体在成年人中具有致心律失常作用，可能涉及亚临床的心脏内炎症过程。尽管炎症与缺血性心脏病（IHD）之间存在明确的关联，但值得注意的是，到目前为止，尚无研究深入探讨这些抗体与 IHD 之间的潜在联系。这项基于人群的研究旨在探讨一般成年人群中抗 Ro/La 血清阳性与 IHD 之间的关联。

方法

我们使用以色列最大的健康维护组织的电子病历进行了回顾性研究。纳入了抗 Ro 和抗 La 抗体血清阳性的患者，并与匹配的对照组进行了比较。采用多变量逻辑回归模型评估血清阳性患者与对照组相比患 IHD 的几率。

结果

在 17231 例血清阳性患者和 84368 例对照组中，血清阳性组的 IHD 发生率明显更高（9.7% vs. 8.1%，OR=1.23；95%CI 1.14-1.31；p<0.001）。这种关联在年龄较小的患者中更为明显（<40 岁（OR=3.36；95%CI 1.66-6.82；p<0.001）、40-49 岁（OR=1.85；95%CI 1.26-2.73；p<0.01）、50-59 岁（OR=1.87；95%CI 1.55-2.26；p<0.001）、60-69 岁（OR=1.26；95%CI 1.11-1.42；p<0.001）、≥70 岁（OR=1.11；95%CI 1.03-1.20；p<0.01）），以及心血管危险因素较少的患者中（无：OR=1.29；95%CI 1.09-1.77；p<0.01，1-2：OR=1.30；95%CI 1.19-1.41；p<0.001，≥3：OR=1.09；95%CI 0.99-1.21；p=0.076）。