高安動脈炎患者の冠動脈疾患の危険因子について検討した

A study on the risk factors of coronary artery disease in patients with Takayasu arteritis.

• Yang Wang
• Shu-Jie Jia
• Yun Zhou
• Jing Li
• Xin Zhao
• Quan-Ming Zhao
• Guan-Lin Yang

抄録

背景:

本研究の目的は，冠動脈が関与する高安動脈炎（TA）の危険因子を検討することであった．

Background: The aim of this study was to investigate the risk factors of Takayasu arteritis (TA) involving the coronary artery.

方法:

本研究では、冠動脈を侵した高安動脈炎患者を対象とした。冠動脈病変の状態に応じて、A群：冠動脈病変を有する[少なくとも1つの冠動脈狭窄(50%以上)を有する]群と、B群：冠動脈病変を有さない群の2群に分類した。ロジスティック回帰モデルを用いて、患者の冠動脈病変を伴う動脈炎の危険因子を解析した。

Methods: Patients with TA involving coronary artery were included in this study. According to the patients' condition of coronary artery involvement, they were divided into two groups: group A: TA involved coronary artery disease [at least one coronary artery stenosis (≥50%)] and group B: TA did not involve coronary artery. A logistic regression model was used to analyze the risk factors of arteritis involving the patients' coronary artery lesions.

結果:

本研究には442名のTA患者が参加した。A群はB群に比べて有意に高齢であった（52.54±11.17 37.73±12.72、P<0.001）。A群の発症年齢はB群の患者よりも有意に高かった（42.21±11.46 32.74±13.13，P＜0.001）。A群では、B群に比べて病期が長く(P<0.001)、BMIが高く(P=0.002)、喫煙、飲酒、糖尿病、脂質異常症(P<0.05)の割合が高かった。また、冠動脈を含むTAの危険因子は、発症年齢（OR=1.143、95％CI:1.007-1.298、P=0.039）、TAの経過（OR=1.165、95％CI:1.025-1.324、P=0.020）、BMI（OR=1.100、95％CI:1.021-1.185、P=0.013）であった。

Results: A total of 442 TA patients were included in this study. The patients were significantly older in group A than those patients in group B (52.54±11.17 37.73±12.72, P<0.001). The age of onset in group A was significantly older than those patients in group B (42.21±11.46 32.74±13.13, P<0.001). The patients in group A had a longer course of disease (P<0.001), larger BMI (P=0.002) and higher rates of smoking, drinking, diabetes, dyslipidemia (P<0.05) when compared with group B. The level of eGFR was significantly decreased and the UA and TG levels were significantly increased in group A when compared with group B(P<0.05). Besides, the risk factors for TA involving coronary artery included the age of TA onset (OR =1.143, 95% CI: 1.007-1.298, P=0.039), course of TA (OR =1.165, 95% CI: 1.025-1.324, P=0.020), and BMI (OR =1.100, 95% CI: 1.021-1.185, P=0.013).

結論:

TA発症年齢が遅く、発症経過が長く、動脈硬化に関連する伝統的な危険因子が多い患者ほど、冠動脈への侵襲を受けやすく、これは臨床的な疾患活動とは無関係である可能性がある。

Conclusions: The later the age of TA onset, the longer the course of TA onset and the more traditional risk factors associated with atherosclerosis, the more vulnerable patients are to coronary artery involvement and this may not be related to clinical disease activity.

2020 Journal of Thoracic Disease. All rights reserved.