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Factors associated with incident severe pulmonary arterial hypertension in systemic autoimmune rheumatic diseases: a nationwide study.
Chen, Hsin-Hua; Lin, Ching-Heng; Hsieh, Tsu-Yi; Chen, Der-Yuan; Ying, Jia-Ching; Chao, Wen-Cheng.
Afiliação
  • Chen HH; Department of Medical Research.
  • Lin CH; Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital.
  • Hsieh TY; Institute of Biomedical Science and Rong Hsing Research Centre for Translational Medicine, Chung Hsing University.
  • Chen DY; Department of Industrial Engineering and Enterprise Information, Tunghai University.
  • Ying JC; School of Medicine, China Medical University, Taichung.
  • Chao WC; Department of Medical Research.
Rheumatology (Oxford) ; 60(11): 5351-5361, 2021 11 03.
Article em En | MEDLINE | ID: mdl-33547781
ABSTRACT

OBJECTIVE:

To assess the association of severe pulmonary arterial hypertension (PAH) with particulate matter <2.5 µm (p.m.2.5) and clinical data in patients with systemic autoimmune rheumatic diseases (SARDs).

METHODS:

We used the 2003-2017 nationwide data in Taiwan to identify patients with SARDs, including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, dermatomyositis/polymyositis and primary Sjögren's syndrome. We identified 479 cases with severe PAH and selected controls matched (14) for age, sex, and index year. We used conditional logistic regression analysis to determine factors associated with risks for severe PAH shown as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS:

We found that severe PAH was highly associated with interstitial lung disease (OR, 8.57; 95% CI 5.52, 13.32), congestive heart failure (OR, 7.62; 95% CI 5.02, 11.55), valvular heart disease (OR, 3.34; 95% CI 2.03, 5.50) and slightly associated with thyroid diseases (OR, 1.88; 95% CI 1.18, 3.00), but not the level of exposure to p.m.2.5. Increased risk for PAH was found in patients receiving corticosteroid (prednisolone equivalent dosage, mg/day, OR, 1.03; 95% CI 1.01, 1.05), biologics (OR, 2.18; 95% CI 1.15, 4.12) as well as immunosuppressants, including ciclosporin (OR, 2.17; 95% CI 1.31, 3.59), azathioprine (OR, 1.96; 95% CI 1.48, 2.61), cyclophosphamide (OR, 2.01; 95% CI 1.30, 3.11) and mycophenolate mofetil/mycophenolic acid (OR, 2.42; 95% CI 1.37, 4.27), and those with the highest level of insured amount (reference, lowest level; OR, 0.53; 95% CI 0.34, 0.83).

CONCLUSION:

The population-based study identified risks for severe PAH in patients with SARDs, and these findings provide evidence for PAH risk stratification in patients with SARDs.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Reumáticas / Hipertensão Arterial Pulmonar Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Reumáticas / Hipertensão Arterial Pulmonar Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Rheumatology (Oxford) Assunto da revista: REUMATOLOGIA Ano de publicação: 2021 Tipo de documento: Article