Risk Assessment Of Cardiovascular Diseases In AAV Patients And ANCA Single Center Epidemiological Investigation

Objective: Investigate the detection of anti-neutrophil cytoplasmic antibody(ANCA)-related vasculitis(AAV)inthepopulation of patients in Dali People’s Hospital,andpredicttheprevalence of cardiovascular disease in patients with AAV in the next 10 years based on Framingham cardiovascular risk assessment.The difference of cardiovascular risk factors between nephropathy groupandnon-nephropathygroupin AAVpatients.Methods: 1.Collect all ANCA positive patients in our hospital from March 2015 to October 2020 through the hospital electronic medical record system,including name,gender,age,visit time,visit department,ANCAtesttime,ANCAtestresults,andfinaldiagnosisofthepatient.2.According to Framingham cardiovascular risk score,AAV patients were divided into high risk group(FRS > 20%),medium risk group(10% < FRS ≤ 20%)and low risk group(FRS ≤ 10%).3.Divide AAV patients into two groups: AAV nephropathy group(46 cases)and non-nephropathy group(17 cases),Start with aspects such as gender,age,smoking,history of diabetes,high blood pressure,blood lipids,renal function indicators,BMI,Framingham cardiovascular risk score,etc.Compare the differences in cardiovascular risk factors between the two groups.Results:1.During the study period,there were 314470 inpatients in the whole hospital,and 21759 ANCA tests were performed.The ANCA test rate was 6.92%,of which 365cases(1.68%)were positive,corresponding to 273 patients(male:female=144:129).The positive detection rate of males(1.73%)and females(1.62%)were not statistically significant(P>0.05).Among the 273 ANCA-positive patients,MPO-ANCA accounted for 80.95%(n=221),PR3-ANCA accounted for 16.85%(n=46),and patients with both MPO-ANCA and PR3-ANCA accounted for 2.20%(n=6).The age distribution of ANCA-positive patients ranges from 15 to 91 years old,with a median age of 62 years old,and the majority of them are middle-aged and elderly(>46 years old)(83.15%).2.Among 63 AAV patients,the proportion of cardiovascular disease with a 10-year risk≤10% was 26.98%.The 10-year risk of cardiovascular disease 10%<FRS≤20% is23.81%,the 10-year risk of cardiovascular disease FRS>20% is 49.21%,and the10-year risk of cardiovascular disease>10% is 73.02%.3.Comparing the two groups’ gender,history of hypertension,SBP,DBP,TC,TG,HDL-C,CREA,and the proportion of cardiovascular disease risk more than 10%,Between the two groups was significant difference(P < 0.05).Conclusion:1.The detection rate of ANCA in Dali People’s Hospital is 1.68%,with MPO-ANCA predominantly(80.95%),which is mainly seen in the elderly,and the positive rate of ANCA has nothing to do with gender.2.The risk of cardiovascular disease in patients with AAV in the next 10 years is generally high.Among them,nearly 73.02%(46/63)of patients have a 10-year risk of cardiovascular disease> 10%,and 49.21%(46/63)of patients have cardiovascular disease 10 Annual risk FRS>20%.3.The risk ratio of cardiovascular disease in ANCA-associated vasculitis nephropathy group was significantly higher than that in non-nephropathy group.4.Patients with AAV should undergo regular cardiovascular disease risk asses sment and actively take measures to reduce the risk of disease.