Framingham评分低估了银屑病关节炎患者的心血管疾病风险

多数新诊断为银屑病关节炎 的患者心血管疾病风险增加，而这一点则被Framinghanm风险评分明显低估，这是基于一项回顾性、人群队列研究的发现。

梅奥诊所的Floranne C. Ernste博士及其同事报告称，“在10年随访期间，126例年龄≥30岁、且无心血管病（CVD）史的银屑病关节炎患者Framingham风险评分的均值为9.7%。不过，10年期间CVD事件的累积发生率几乎翻倍，为17%（标准化发生率比值为1.8）。基于年龄的分析表明，这些患者40岁后的CVD风险一直是FRS初始预测的2倍”。

这些发现强调了银屑病关节炎患者CVD风险评估的重要性，但也提示Framingham风险评分可能不适用于这些患者，研究者说，并补充道“这些研究形象地说明了非常需要发展针对银屑病关节炎患者CVD风险评估的工具，这是进一步研究的焦点。”

这些发现结果还提示，为了“减轻长期CVD负担”，他们说，银屑病关节炎病程早期可能即应展开积极的治疗。

这一研究由罗切斯特流行病学项目（Rochester Epidemiology Project）与安进（Amgen）公司资助。Ernste博士没有任何利益冲突披露。

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Most newly diagnosed psoriatic arthritis patients have an increased risk for cardiovascular disease that is markedly underestimated by the Framingham Risk Score, according to findings from a retrospective, population-based, cohort study.

The mean Framingham Risk Score in 126 patients with psoriatic arthritis who were aged 30 years or older and who had no prior cardiovascular disease (CVD) history, was 9.7% during the first 10 years of follow-up. However, the 10-year cumulative incidence of CVD events was nearly double that at 17% (standardized incidence ratio, 1.80), Dr. Floranne C. Ernste of the Mayo Clinic, Rochester, Minn., and her colleagues reported (Arthritis Care Res. 2015 Jan. 7 [doi:10.1002/acr.22536]).

Age-based analysis showed that the CVD risk in these patients was consistently twice as high as predicted by the FRS beginning after age 40 years, the authors noted.

The findings underscore the importance of CVD risk assessment in patients with psoriatic arthritis but suggest that the Framingham Risk Score may not be applicable in such patients, the investigators said, adding that “This study serves to illustrate the important need for further research to focus on the development of CVD risk assessment tools specific to psoriatic arthritis patients.”

The findings also suggest that aggressive therapy may be warranted early in the course of psoriatic arthritis to “attenuate the long-term burden of CVD,” they said.

This study was supported by the Rochester Epidemiology Project and by Amgen. Dr. Ernste reported having no disclosures.

Copyright © 2015 Frontline Medical News, a Frontline Medical Communications, Inc. company. All rights reserved. This material may not be published, broadcast, copied or 

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