Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases

被引:6
作者
Sinha, Arjun [1 ,2 ]
Rivera, Adovich S. [2 ,3 ]
Chadha, Simran A. [4 ]
Prasada, Sameer [1 ]
Pawlowski, Anna E. [5 ]
Thorp, Edward [6 ]
DeBerge, Matthew [6 ]
Ramsey-Goldman, Rosalind [1 ]
Lee, Yvonne C. [1 ]
Achenbach, Chad J. [1 ]
Lloyd-Jones, Donald M. [1 ,2 ]
Feinstein, Matthew J. [1 ,2 ]
机构
[1] Northwestern Univ, Dept Med, Feinberg Sch Med, Chicago, IL 60611 USA
[2] Northwestern Univ, Dept Prevent Med, Feinberg Sch Med, Chicago, IL 60611 USA
[3] Northwestern Univ, Inst Publ Hlth & Management, Feinberg Sch Med, Chicago, IL 60611 USA
[4] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA
[5] Northwestern Univ, Northwestern Med Enterprise Data Warehouse, Chicago, IL 60611 USA
[6] Northwestern Univ, Dept Pathol, Feinberg Sch Med, Chicago, IL 60611 USA
基金
美国国家卫生研究院;
关键词
coronary heart disease; lupus (SLE); systemic sclerosis; inflammation; rheumatoid arthritis; HIV-human immunodeficiency virus; psoriasis; SYSTEMIC-LUPUS-ERYTHEMATOSUS; ELECTRONIC MEDICAL-RECORD; MYOCARDIAL-INFARCTION; CARDIOVASCULAR MORTALITY; RHEUMATOID-ARTHRITIS; DIABETES-MELLITUS; POPULATION; VALIDATION; PSORIASIS; VALIDITY;
D O I
10.3389/fcvm.2021.757738
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs.Objective: Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD).Methods: The cohort included patients with CIDs and controls without CID in an urban medical system from 2000 to 2019. Patients with CIDs were frequency-matched with non-CID controls on demographics, hypertension, and diabetes. CHD was defined as myocardial infarction (MI), ischemic heart disease, and/or coronary revascularization based on validated administrative codes. Multivariable-adjusted Cox models were used to determine the risk of incident CHD and MI for each CID relative to non-CID controls. In secondary analyses, we compared CHD risk by disease severity within each CID.Results: Of 17,049 patients included for analysis, 619 had incident CHD (202 MI) over an average of 4.4 years of follow-up. The multivariable-adjusted risk of CHD was significantly higher for SLE [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.2, 3.2] and SSc (HR 2.1, 95% CI 1.2, 3.9). Patients with SLE also had a significantly higher risk of MI (HR 3.6, 95% CI 1.9, 6.8). When CIDs were categorized by markers of disease severity (C-reactive protein for all CIDs except HIV, for which CD4 T cell count was used), greater disease severity was associated with higher CHD risk across CIDs.Conclusions: Patients with SLE and SSc have a higher risk of CHD. CHD risk with HIV, RA, psoriasis, and IBD may only be elevated in those with greater disease severity. Clinicians should personalize CHD risk and treatment based on type and severity of CID.
引用
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页数:10
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