| Objective: Rheumatoid arthritis(RA)is a common autoimmune inflammatory disease with chronic and symmetric multiple synovial arthritis as the main clinical manifestation.The prevalence of RA in China is 0.32% to 0.36%.The probability of cardiovascular events in patients with RA is 40% to 50%,which has become the leading cause of RA death.In particular,the incidence of coronary heart disease(CHD)in patients with RA is significantly higher,which is one of the serious complications of RA.The risk of coronary artery disease in RA patients is 1.5 to 2.0 times greater than in the general population.Traditional atherosclerotic risk factors such as smoking,hypertension,dyslipidemia,diabetes,obesity,and physical activity are associated with the development of atherosclerosis in RA patients,but after adjusting for risk factors associated with traditional atherosclerosis The incidence of atherosclerosis in RA patients is still about three times that of the general population.Therefore,in order to explore the risk factors of CHD in patients with RA,especially the relationship between serum lipids,inflammatory markers and coronary markers such as CHD,this study explored the intrinsic link between CHD and CHD based on electronic disease.data.It is extremely important to improve the quality of life of patients with RA and prevent the occurrence and diagnosis of cardiovascular disease.Materials and methods: This study collected data on electronic medical records from January 2010 to December 2017 in the First Affiliated Hospital of China Medical University.The inclusion of exclusion criteria included in the RA combined CHD group,and patients with RA who matched their age and gender,There were 401 patients with CHD alone and control patients.Univariate analysis was used to explore the risk factors of CHD in patients with RA.Analyze the correlation between blood lipid levels and inflammatory factors and CHD risk in patients with rheumatoid arthritis by logistic regression.A dose-response relationship between the risk of CHD in patients with rheumatoid arthritis was explored using a Restricted cubic spline(RCS)function combined with logistic regression.Results:A total of 1604 subjects were included in the study.Multiple comparisons of blood lipid levels between groups and comparison of inflammatory markers and serological status between RA patients with and without CHD were performed to screen for significant serum biochemical levels,and further multivariate analysis was performed to investigate serum lipid levels,inflammatory factors and RA in patients with RA.1.The patients with positive anti-CCP antibody(P<0.001),high ESR levels(P<0.001)and dislipidemia in the RA+CHD group were more than the RA group,and the difference was statistically significant.2.Multivariate analysis found that the independent risk factors for CHD in patients with RA were history of hypertension OR=3.65,95% CI: 2.64-5.01,P<0.001)and anti-CCP antibody positive(OR=1.45,95% CI: 1.06-1.97,P=0.020),high blood lipid LDL-c level(OR=2.11,95% CI: 1.23-3.64,P<0.001),high blood lipid TG level(OR=1.53,95% CI: 1.03-2.26,P=0.033),high ESR levels(OR=1.82,95% CI: 1.24-2.26,P=0.002);3.Dose-response analysis found that there was a nonlinear relationship between serum TG levels and ESR levels and CHD risk in RA patients.Conclusion:The results suggest that history of hypertension,anti-CCP antibody,high-lipid LDL-c levels,high-lipid TG levels,and high ESR levels are important risk factors for CHD in RA patients.These findings can promote and improve the treatment of patients with RA,improve prognostic strategies and measures,and prevent CHD in patients with RA.In actual clinical applications,patients with RA with a history of hypertension,anti-CCP antibody-positive,and dyslipidemia should be given more attention to prevent CHD risk in RA patients.At the same time,prospective studies of long-term follow-up are needed to better understand the relationship between serological markers and CHD in RA patients. |
PDF Full Text Request