类风湿性关节炎与心血管疾病之间的遗传关系:孟德尔随机研究的系统回顾。

IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Mathias Ausserwinkler, Sophie Gensluckner, Andreas Voelkerer, Jens Thiel, Hans-Jörg Neumann, Maria Flamm, Christian Datz, Elmar Aigner, Bernhard Wernly
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引用次数: 0

摘要

目的:类风湿性关节炎(RA)是一种慢性自身免疫性疾病,伴有全身炎症和关节损伤。它作为心血管疾病(CVD)风险因素的潜在作用日益受到关注。本综述通过孟德尔随机分析法(MR)从遗传学角度深入探讨 RA 与心血管疾病之间的因果关系:方法:在 PubMed、Cochrane 和 Web of Science 中进行了广泛搜索,以确定有关 RA 与心血管疾病关系的 MR 研究。在 530 项研究中,有 9 项符合纳入标准,并使用批判性评估清单对其进行了严格评估。通过敏感性分析,这些研究被进一步分层,以反映其证据的强度,从不可评估到可靠:在纳入的九项研究中,八项研究支持RA与心血管疾病(尤其是冠状动脉疾病)风险增加之间存在因果关系,一项研究不支持RA与心力衰竭之间存在联系。研究结果表明,与 RA 相关的遗传因素可能会导致心血管疾病风险升高。RA中普遍存在的慢性炎症是这一联系的关键介质:系统综述证实了 RA 与心血管疾病之间的遗传因果关系,综述的九项 MR 研究中有八项证明了这一点。这表明,在治疗 RA 患者时,需要对心血管风险进行综合管理。研究结果主张考虑可降低心血管风险的抗炎治疗。总体证据为旨在增强 RA 患者心血管健康的新治疗策略指明了潜在的方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Genetic relationship between rheumatoid arthritis and cardiovascular diseases : A systematic review of Mendelian randomization studies.

Genetic relationship between rheumatoid arthritis and cardiovascular diseases : A systematic review of Mendelian randomization studies.

Objective: Rheumatoid arthritis (RA) is recognized as a chronic autoimmune disorder with systemic inflammation and joint damage. Its potential role as a risk factor for cardiovascular diseases (CVD) is increasingly noted. This review delves into the causal relationship between RA and CVD, with Mendelian randomization (MR) offering a genetic perspective.

Methods: An extensive search was conducted in PubMed, Cochrane and Web of Science to identify MR studies addressing the RA-CVD link. Out of 530 studies, 9 met the inclusion criteria, which were rigorously assessed using a critical appraisal checklist. These were further stratified by a sensitivity analysis into categories reflecting the strength of their evidence, from not evaluable to robust.

Results: From the nine included studies, eight supported a causal association between RA and an increased risk of CVD, specifically coronary artery disease (CAD) and one did not support a link between RA and heart failure. The results suggest that genetic factors associated with RA may contribute to an elevated risk for CVD. Chronic inflammation, prevalent in RA, emerges as a key mediator in this connection.

Conclusion: The systematic review corroborates a genetic causal link between RA and CVD, as evidenced by eight of the nine MR studies reviewed. This suggests a need for integrated cardiovascular risk management in the treatment of RA patients. The findings advocate considering anti-inflammatory treatment that can reduce cardiovascular risk. The overarching evidence signifies a potential direction for new therapeutic strategies aimed at enhancing cardiovascular health in RA patients.

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来源期刊
Wiener Klinische Wochenschrift
Wiener Klinische Wochenschrift 医学-医学:内科
CiteScore
4.70
自引率
3.80%
发文量
110
审稿时长
4-8 weeks
期刊介绍: The Wiener klinische Wochenschrift - The Central European Journal of Medicine - is an international scientific medical journal covering the entire spectrum of clinical medicine and related areas such as ethics in medicine, public health and the history of medicine. In addition to original articles, the Journal features editorials and leading articles on newly emerging topics, review articles, case reports and a broad range of special articles. Experimental material will be considered for publication if it is directly relevant to clinical medicine. The number of international contributions has been steadily increasing. Consequently, the international reputation of the journal has grown in the past several years. Founded in 1888, the Wiener klinische Wochenschrift - The Central European Journal of Medicine - is certainly one of the most prestigious medical journals in the world and takes pride in having been the first publisher of landmarks in medicine.
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