巴西南部类风湿关节炎患者缺血性心脏病患病率及相关因素

Rafael Kmiliauskis Santos Gomes , Ana Carolina Albers , Ana Isadora Pianowski Salussoglia , Ana Maria Bazzan , Luana Cristina Schreiner , Mateus Oliveira Vieira , Patrícia Giovana da Silva , Patrícia Helena Machado , Cynthia Mara da Silva , Mauro Marcelo Mattos , Moacyr Roberto Cuce Nobre
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引用次数: 3

摘要

目的了解类风湿关节炎患者缺血性心脏病的患病率及相关因素。方法采用美国风湿病学会诊断标准进行横断面研究,以选择2014年在巴西南部圣卡塔琳娜州Blumenau初级或二级卫生保健单位就诊的患者。缺血性心脏病的存在被定义为诊断后发生经皮冠状动脉介入治疗或冠状动脉搭桥手术的急性心肌梗死。采用Fischer精确检验、Wald线性趋势检验和多变量logistic回归分析对相关性进行检验。结果296例患者(83.1%为女性)平均年龄56.6岁,平均类风湿关节炎病程11.3年,其中13例报告急性心肌梗死需要经皮或手术再灌注手术,患病率为4.4% (95% CI 2.0-6.7)。多因素分析后,糖尿病(比值比[OR] 4.9 [95% CI 1.6-13.8])和疾病持续时间(OR 8.2 [95% CI 1.8-39.7])是最终模型中仅存的与缺血性疾病相关的因素。结论急性心肌梗死的发生率与其他研究相似。在传统危险因素中,糖尿病和类风湿关节炎相关因素中,病程是与合并症相关的变量。
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Prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis in Southern Brazil

Objective

To estimate the prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis.

Methods

A cross-sectional study using the American College of Rheumatology diagnostic criteria in order to select patients seen at primary or secondary health care units in Blumenau, Santa Catarina, Southern Brazil, in 2014. The presence of ischemic heart disease was defined as an acute myocardial infarction with percutaneous coronary intervention or coronary artery bypass graft surgery that has occurred after diagnosis. Fischer's exact test, Wald's linear trend test, and multivariate logistic regression analysis were used to test the associations.

Results

Among 296 patients (83.1% female) with a mean age of 56.6 years and a mean rheumatoid arthritis duration of 11.3 years, 13 reported having acute myocardial infarction requiring a percutaneous or surgical reperfusion procedure, a prevalence of 4.4% (95% CI 2.0–6.7). Diabetes Mellitus (odds ratio [OR] 4.9 [95% CI 1.6–13.8]) and disease duration >10 years (OR 8.2 [95% CI 1.8–39.7]) were the only factors associated with an ischemic disease that remained in the final model, after the multivariate analysis.

Conclusion

The prevalence of acute myocardial infarction was similar to that observed in other studies. Among the traditional risk factors, Diabetes Mellitus, and among the factors related to rheumatoid arthritis, disease duration, were the variables associated with comorbidity.

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