Utilizing Clinical and Non-clinical Patient Factors in Predicting Cardiovascular Events in Patients on JAK Inhibitor Therapy: A Retrospective Cohort Study

利用临床和非临床患者因素预测JAK抑制剂治疗患者心血管事件:一项回顾性队列研究

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Abstract

BACKGROUND: Patients with autoimmune rheumatic diseases (ARDs) taking JAK inhibitors may have an increased risk of cardiovascular events, especially if they have other health conditions. Identifying high-risk patients can inform targeted preventive care. This study assessed the value of age and deprivation decile in predicting cardiovascular events in patients on JAK inhibitors for ARDs. OBJECTIVE: To assess the predictive value of age and deprivation decile in identifying patients at risk of cardiovascular events while on JAK inhibitor therapy for ARDs. METHODS: This cross-sectional cohort study enrolled 309 patients with ARDs (mean age 59.3 years, 77% female) treated with JAK inhibitors at a UK teaching hospital. Baseline characteristics, including age, gender, ethnicity, and comorbidities, were collected. Cardiovascular events (myocardial infarctions, strokes, and cardiovascular-related deaths) that occurred while on JAK inhibitor therapy were identified retrospectively. Deprivation indices were calculated using socioeconomic factors. RESULTS: Multivariate logistic regression analysis, adjusting for potential confounders, showed that a model combining age and deprivation decile was statistically significant (p = 0.031) in predicting cardiovascular events. Neither age nor deprivation decile alone was statistically significant. Older patients had an odds ratio of 1.06 (95% CI: 1.00-1.13) for increased risk of cardiovascular events. The logistic regression model as a whole was statistically significant (Chi2(14) = 24.04, p = 0.031, n = 309). The AUC of the ROC curve was 0.837. CONCLUSION: Age and deprivation decile can effectively predict cardiovascular events in patients on JAK inhibitor therapy for ARDs. Incorporating these predictive tools into routine clinical practice can help identify patients who warrant intensified cardiovascular risk management.

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