RESUMEN
Objective To explore the prevalence and influencing factors of coronary atherosclerotic heart disease (CHD) in rheumatoid arthritis (RA) patients during past 10 years. Methods A total of 5 426 RA patients were selected from Jan. 1, 2009 to Mar. 20, 2019 in the Tianjin First Central Hospital, and 1 483 osteoarthritis (OA) patients were selected as controls. Basic information, laboratory indicators, prevalence of CHD and related complications, and drug use of RA and OA patients were collected and compared. The influencing factors of CHD prevalence in RA patients were analyzed by logistic regression. Results There was no significant difference in the prevalence of CHD between male and female RA patients (32.1%, 321/1 000 vs 32.3%, 323/1 000; χ2＝0.02, P＝0.90). The prevalence rates of CHD, hyperlipidemia and hypertension in RA patients were significantly increased in the past 10 years (χ2＝115.67, 129.41, 193.81, all P＜0.01), while the prevalence of diabetes mellitus was significantly decreased after 2014 (χ2＝29.99, P＜0.01). After propensity score matching of 1∶1 by age and gender, there was no significant difference in CHD prevalence between the RA and OA patients (P＝0.74). The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin 2 receptor (IL-2R), interleukin 6 (IL-6), high density lipoprotein-cholesterol (HDL-C), rheumatoid factor (RF), anti-cyclic citrullinated peptide (ACCP), D-dimer, fibrinogen (FiB) and creatine kinase-myocardial band (CK-MB), and positive rate of anti-keratin antibody (AKA) were significantly higher in the RA patients than those in the OA patients, while the levels of creatine kinase (CK) and blood glucose were significantly lower than those in the OA patients (all P＜0.05). The levels of ESR, CRP, total cholesterol, low density lipoprotein-cholesterol (LDL-C), triglyceride, immunoglobulin G-rheumatoid factor (IgG-RF), ACCP, FiB, blood glucose and uric acid, and the positive rate of AKA were all significantly higher in the RA patients with CHD than those in the RA patients without CHD, while the levels of HDL-C, immunoglobulin G (IgG), immunoglobulin M (IgM) and 25-hydroxyvitamin D were significantly lower than those in the RA patients without CHD (all P＜0.05). Logistic regression analysis showed that the prevalence of CHD was negatively correlated with the levels of total cholesterol, ACCP, IgG and 25-hydroxyvitamin D, but positively correlated with the levels of IgG-RF and uric acid in PA patients (all P＜0.05). Conclusion In clinical treatment, we should pay more attention to the risk factors of CHD in RA patients so as to select more targeted and effective RA treatment, reducing the risk of CHD and improving the quality of life of patients.