Beecher Grayson, Muhammad Sara, Shammas Ibrahim, Chamberlain Alanna M, Larson Kathryn, Mandrekar Jay, Harmsen William S, Naddaf Elie
Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Eur J Neurol. 2025 May;32(5):e70177. doi: 10.1111/ene.70177.
Idiopathic inflammatory myopathies, beyond inclusion body myositis (IBM), have demonstrated an increased risk of adverse cardiovascular outcomes, particularly myocardial infarction (MI). This study evaluated the risk of cardiovascular disease in IBM.
We conducted a non-concurrent cohort study utilizing the expanded Rochester Epidemiologic Project, including 50 patients with IBM, matched 1:6 to age-, sex-, and calendar year-matched referents without IBM. Baseline cardiovascular risk factors were recorded. Differences in baseline covariates were adjusted by the inverse probability of treatment weighting method. Participants were followed from the index date forward to determine relative risks (RR) and hazard ratios (HR) for the development of cardiovascular outcomes including MI, ischemic stroke, cardiomyopathy, congestive heart failure (CHF), and peripheral vascular disease (PVD).
50 patients with IBM and 294 matched population referents were included. Baseline cardiovascular risk factors were similar between groups. Aspirin use was more common (28% vs. 18%, p = 0.03) and statin use less common (26% vs. 38%, p = 0.04) in IBM versus referents. Patients with IBM had an increased hazard of MI compared to referents [HR: 5.79, 95% CI (2.51, 13.36)]. The risk of MI remained consistently elevated across all models, after accounting for potential confounders. For PVD, 16/50 IBM patients versus 16/287 referents were excluded due to pre-existing PVD at index (p < 0.001). Among remaining participants, RR for PVD was 2.38 (0.82, 6.9). IBM was not associated with an increased risk of ischemic stroke, cardiomyopathy, or CHF.
IBM is associated with increased risk of MI compared to population referents. Heightened cardiovascular monitoring and prevention strategies are needed in IBM.
除包涵体肌炎（IBM）外，特发性炎性肌病已显示出不良心血管结局风险增加，尤其是心肌梗死（MI）。本研究评估了IBM患者发生心血管疾病的风险。
我们利用扩展的罗切斯特流行病学项目进行了一项非同期队列研究，纳入50例IBM患者，按1:6与年龄、性别和日历年份匹配的无IBM对照者配对。记录基线心血管危险因素。通过治疗权重逆概率法调整基线协变量差异。从索引日期开始对参与者进行随访，以确定发生心血管结局（包括MI、缺血性中风、心肌病、充血性心力衰竭（CHF）和外周血管疾病（PVD））的相对风险（RR）和风险比（HR）。
纳入了50例IBM患者和294名匹配的人群对照者。两组间基线心血管危险因素相似。与对照者相比，IBM患者使用阿司匹林更为常见（28%对18%，p = 0.03），而使用他汀类药物则较少见（26%对38%，p = 0.04）。与对照者相比，IBM患者发生MI的风险更高[HR：5.79，95%CI（2.51，13.36）]。在考虑潜在混杂因素后，MI风险在所有模型中均持续升高。对于PVD，由于索引时已存在PVD，50例IBM患者中有16例被排除，287名对照者中有16例被排除（p < 0.001）。在其余参与者中，PVD的RR为2.38（0.82，6.9）。IBM与缺血性中风、心肌病或CHF风险增加无关。
与人群对照者相比，IBM患者发生MI的风险增加。IBM患者需要加强心血管监测和预防策略。
