| アブストラクト | OBJECTIVE: To investigate the incidence and risk of ischaemic heart disease (IHD) and acute myocardial infarction (AMI), including the role of non-steroidal anti-inflammatory drugs (NSAID), in patients with ankylosing spondylitis (AS) compared with population controls. METHODS: All patients with newly diagnosed AS (n=3809) from the British Clinical Practice Research Datalink (1987-2012) were matched with up to seven persons without AS by year of birth, gender and practice (n=26 197). Incidence rate ratios (IRR) and HRs for development of IHD and AMI were calculated. Stepwise analyses were performed adjusting for age, gender, comorbidity and drug use, including NSAIDs. RESULTS: At baseline, 4.3% of the patients had IHD and 1.8% had AMI compared with 3.4% and 1.4% of the controls, respectively. After exclusion of pre-existing IHD or AMI, the IRRs were 1.18 (95% CI 0.96 to 1.46) and 0.91 (95% CI 0.65 to 1.27) for IHD and AMI, respectively. Compared with controls, the age-gender adjusted HR for developing IHD was 1.20 (95% CI 0.97 to 1.48), and for AMI 0.91 (95% CI 0.65 to 1.28). In female patients, the risk of developing IHD was increased (HR 1.88, 95% CI 1.22 to 2.90), but after adjustment for all possible risk factors only a non-significant trend was found (HR 1.31, 95% CI 0.83 to 2.08). In particular, NSAID use explained this change (HR IHD adjusted for age-gender-NSAID use 1.57, 95% CI 0.99 to 2.48). CONCLUSIONS: Female patients with AS had an increased age-adjusted risk of developing IHD, but after adjustment for NSAID use only a non-significant trend towards increased risk was found. |
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| ジャーナル名 | Annals of the rheumatic diseases |
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| 投稿日 | 2014/11/2 |
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| 投稿者 | Essers, Ivette; Stolwijk, Carmen; Boonen, Annelies; De Bruin, Marie L; Bazelier, Marloes T; de Vries, Frank; van Tubergen, Astrid |
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| 組織名 | Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for;Pharmaceutical Sciences, Utrecht, The Netherlands Department of Rheumatology,;Maastricht University Medical Center, Maastricht, The Netherlands Care and Public;Health Research Institute (CAPHRI), Maastricht, The Netherlands.;Department of Rheumatology, Maastricht University Medical Center, Maastricht, The;Netherlands Care and Public Health Research Institute (CAPHRI), Maastricht, The;Netherlands.;Pharmaceutical Sciences, Utrecht, The Netherlands.;Pharmaceutical Sciences, Utrecht, The Netherlands Care and Public Health Research;Institute (CAPHRI), Maastricht, The Netherlands Department of Clinical Pharmacy;and Toxicology, Maastricht University Medical Centre, Maastricht, The Netherlands;MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25362044/ |
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