Vascular calcifications on hand radiographs in rheumatoid arthritis and associations with autoantibodies, cardiovascular risk factors and mortality

被引：8

作者：

Solow, E. Blair ^{[1
]}

Yu, Fang ^{[2
]}

Thiele, Geoffrey M. ^{[3
]}

Sokolove, Jeremy ^{[4
]}

Robinson, William H. ^{[4
]}

Pruhs, Zachary M. ^{[3
]}

Michaud, Kaleb D. ^{[3
,5
]}

Erickson, Alan R. ^{[3
]}

Sayles, Harlan ^{[3
]}

Kerr, Gail S. ^{[6
]}

Gaffo, Angelo L. ^{[7
]}

Caplan, Liron ^{[8
]}

Davis, Lisa A. ^{[8
]}

Cannon, Grant W. ^{[9
]}

Reimold, Andreas M. ^{[1
,10
]}

Baker, Joshua ^{[11
]}

Schwab, Pascale ^{[12
]}

Anderson, Daniel R. ^{[13
]}

Mikuls, Ted R. ^{[3
]}

机构：

[1] UT Southwestern, Div Rheumat Dis, Dallas, TX USA

[2] Univ Nebraska Med Ctr, Coll Publ Hlth, Dept Biostat, Omaha, NE USA

[3] Omaha Vet Affairs Med Ctr, Div Rheumatol & Immunol, Omaha, NE 68198 USA

[4] VA Palo Alto Hlth Care Syst, Div Rheumatol, Palo Alto, CA USA

[5] Natl Data Bank Rheumat Dis, Wichita, KS USA

[6] Vet Affairs Med Ctr, Dept Med, Washington, DC 20422 USA

[7] Birmingham Vet Affairs Med Ctr, Dept Med, Birmingham, AL USA

[8] Denver Vet Affairs Med Ctr, Div Rheumatol, Denver, CO USA

[9] George Wahlen Vet Affairs Med Ctr, Div Rheumatol, Salt Lake City, UT USA

[10] Dallas Vet Affairs Med Ctr, Div Rheumatol, Dallas, TX USA

[11] Philadelphia Vet Affairs Med Ctr, Div Rheumatol, Philadelphia, PA USA

[12] Portland VA Med Ctr, Div Rheumatol, Portland, OR USA

[13] Univ Nebraska Med Ctr, Div Cardiol, Omaha, NE USA

来源：

RHEUMATOLOGY | 2015年 / 54卷 / 09期

关键词：

rheumatoid arthritis; vascular calcifications; hand radiographs; anti-citrullinated protein autoantibodies; mortality; SMOOTH-MUSCLE-CELLS; DISEASE-ACTIVITY; CORONARY ATHEROSCLEROSIS; ARTERIAL CALCIFICATION; MYOCARDIAL-INFARCTION; ALPHA THERAPY; BONE LOSS; OSTEOPOROSIS; MICE; INTERLEUKIN-4;

D O I：

10.1093/rheumatology/kev027

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. To examine whether vascular calcifications on hand films in RA might aid in determining mortality risk. Methods. Hand radiographs from 906 RA patients were scored as positive or negative for vascular calcifications. Patient characteristics associated with vascular calcifications were assessed using multivariable logistic regression, and associations with mortality were examined using Cox proportional hazards regression. Cytokines and multiplex ACPA were measured in both groups. Results. A total of 99 patients (11%) demonstrated radiographic vascular calcifications. Factors independently associated with vascular calcifications included diabetes [odds ratio (OR) 2.85; 95% CI 1.43, 5.66], cardiovascular disease at enrolment (OR 2.48; 95% CI 1.01, 6.09), prednisone use (OR 1.90; 95% CI 1.25, 2.91), current smoking (OR 0.06; 95% CI 0.01, 0.23) and former smoking (OR 0.36; 95% CI 0.27, 0.48) vs never smoking. In cytokine and ACPA subtype analysis, IL-4 and anti-citrullinated apolipoprotein E were significantly increased in patients with vascular calcifications in fully adjusted multivariable models. After multivariable adjustment, vascular calcifications were associated with an increase in all-cause mortality (hazard ratio 1.41; 95% CI 1.12, 1.78; P = 0.004). Conclusion. Vascular calcifications on hand radiographs were independently associated with increased all-cause mortality in RA. Mechanisms underpinning the associations of IL-4 and select ACPA with vascular calcifications and their utility as biomarkers predictive of cardiovascular disease risk in RA merit further study.

引用

页码：1587 / 1595

页数：9

共 47 条

[11] (Sub) clinical cardiovascular disease is associated with increased bone loss and fracture risk; a systematic review of the association between cardiovascular disease and osteoporosis [J].