Five-year cardiovascular event risk in early rheumatoid arthritis patients who received treat-to-target management: a case-control study.

Autor:	Lam TO; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China., Cheng IT; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China., Lam SH; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China., Mok CC; Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China., Ho CT; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Cheung TT; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Lao VW; Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China., Pang HT; Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China., To CH; Department of Medicine and Geriatrics, Pok Oi Hospital, Hong Kong, China., Yim CW; Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China., Ng A; Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong, China., Kwok KY; Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China., Lee KL; Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China., Ying SK; Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China., Wan MC; Department of Medicine and Geriatrics, Ruttonjee Hospital, Hong Kong, China., Lee JM; Department of Medicine and Geriatrics, Tai Po Hospital, Hong Kong, China., Tam LS; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2023 Sep 01; Vol. 62 (9), pp. 2998-3005.
DOI:	10.1093/rheumatology/kead039
Abstrakt:	Objectives: This study explored whether the excess cardiovascular (CV) disease (CVD) risk in RA could be ameliorated by suppression of inflammation using a treat-to-target (T2T) approach. We compared the CV event (CVE) incidence among ERA patients managed by a T2T strategy with a CV risk factor-matched non-RA population and a historical RA cohort (HRA). Methods: This was an observational study using the city-wide hospital data and the ERA registry. ERA patients received T2T management while HRA patients received routine care. Each ERA/HRA patient was matched to three non-RA controls according to age, gender and CV risk factors. Patients on antiplatelet/anticoagulant agents, with pre-existing CVD, chronic kidney disease or other autoimmune diseases were excluded. All subjects were followed for up to 5 years. The primary end point was the first occurrence of a CVE. Results: The incidence of CVE in the ERA cohort (n = 261) and ERA controls were similar with a hazard ratio of 0.53 (95% CI 0.15, 1.79). In contrast, the incidence of CVE in the HRA cohort (n = 268) was significantly higher than that of the HRA controls with a hazard ratio of 1.9 (95% CI 1.16, 3.13). The incidence of CVE in the ERA cohort was significantly lower than that of the HRA cohort and the difference became insignificant after adjusting for inflammation, the use of methotrexate and traditional CV risk factors. Conclusion: ERA patients managed by a T2T strategy did not develop excess CVE compared with CV risk factor-matched controls over 5 years. (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu