| アブストラクト | OBJECTIVES: We aimed to quantify the risk of major adverse cardiovascular events (MACE) among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors. METHODS: A population-based longitudinal cohort study from 1994 to 2010 was performed in The Health Improvement Network (THIN), a primary care medical record database in the UK. Patients aged 18-89 years of age with PsA, RA or psoriasis were included. Up to 10 unexposed controls matched on practice and index date were selected for each patient with PsA. Outcomes included cardiovascular death, myocardial infarction, cerebrovascular accidents and the composite outcome (MACE). Cox proportional hazards models were used to calculate the HRs for each outcome adjusted for traditional risk factors. A priori, we hypothesised an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use. RESULTS: Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=81 573) were identified. After adjustment for traditional risk factors, the risk of MACE was higher in patients with PsA not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), patients with RA (No DMARD: HR 1.39, 95% CI 1.28 to 1.50, DMARD: HR 1.58, 95% CI 1.46 to 1.70), patients with psoriasis not prescribed a DMARD (HR 1.08, 95% CI 1.02 to 1.15) and patients with severe psoriasis (DMARD users: HR 1.42, 95% CI 1.17 to 1.73). CONCLUSIONS: Cardiovascular risk should be addressed with all patients affected by psoriasis, PsA or RA. |
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| 投稿者 | Ogdie, Alexis; Yu, YiDing; Haynes, Kevin; Love, Thorvardur Jon; Maliha, Samantha; Jiang, Yihui; Troxel, Andrea B; Hennessy, Sean; Kimmel, Steven E; Margolis, David J; Choi, Hyon; Mehta, Nehal N; Gelfand, Joel M |
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| 組織名 | Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics,;Center for Pharmacoepidemiology Research and Training, Perelman School of;Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.;Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA;Department of Population Medicine, Harvard Medical School, Boston, Massachusetts,;USA.;Center for Clinical Epidemiology and Biostatistics, Center for;Pharmacoepidemiology Research and Training, Department of Biostatistics and;Epidemiology, Perelman School of Medicine at the University of Pennsylvania,;Philadelphia, Pennsylvania, USA.;University of Iceland, Reykjavik, Iceland.;New York University School of Medicine, New York, NY, USA.;Division of Rheumatology, Perelman School of Medicine at the University of;Pennsylvania, Philadelphia, Pennsylvania, USA.;Department of Medicine, Center for Clinical Epidemiology and Biostatistics,;Center for Pharmacoepidemiology Research and Training, Center for Therapeutic;Effectiveness Research, Perelman School of Medicine at the University of;Department of Dermatology, Center for Clinical Epidemiology and Biostatistics,;Center for Dermatoepidemiology and Translation, Perelman School of Medicine at;the University of Pennsylvania, Philadelphia, Pennsylvania, USA.;Section of Rheumatology and the Clinical Epidemiology Unit, Boston University;School of Medicine, Boston, Massachusetts, USA.;Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and;Blood Institute, Bethesda, Maryland, USA.;the University of Pennsylvania, Philadelphia, Pennsylvania, USA Department of;Biostatistics and Epidemiology, Center for Clinical Epidemiology and;Biostatistics, Center for Pharmacoepidemiology Research and Training, Perelman;School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, |
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