Vitamin D and Cardiovascular Events in Rheumatoid Arthritis
Association Between Baseline Vitamin D Metabolite Levels and Risk of Cardiovascular Events in Rheumatoid Arthritis Patients. A Cohort Study With Patient-record Evaluated Outcomes.
研究概览
地位
详细说明
Cardiovascular morbidity and mortality is increased in patients with rheumatoid arthritis (RA), and among these patients, the prevalence of hypo-vitaminosis D is high. Low levels of vitamin D have been associated with elevated cardiovascular risk in healthy subjects. The objective of this study is to evaluate the risk of cardiovascular events in patients having low 25OHD-total levels at baseline compared to patients with sufficient levels, in an aggressively treated closed cohort of early-diagnosed RA patients.
The primary outcome will be the proportion of patients with any cardiovascular event, evaluated using systematic journal audits. Logistic regression models will be applied to test the hypothesis that there are more cardiovascular events in patients enrolled with a low level of vitamin D (< 50 nmol/l). Secondarily, Cox regression models, based on survival analysis, will be applied, to determine the extent to which independent variables (including different levels of vitamin D at baseline) predict not only whether a cardiovascular event occur, but also when it will occur.
研究类型
注册 (实际的)
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria: Fulfilling ACR1987 (American College of Rheumatology 1987 classification criteria for Rheumatoid Arthritis) criteria for RA, disease duration < 6 months, 2 or more swollen joints and age between 18 and 75 years -
Exclusion Criteria: Glucocorticoid treatment 4 weeks prior to inclusion, previous use of DMARDs, malignancy, diastolic blood pressure > 90 mm Hg, elevated serum creatinine, infections with parvovirus B19, Hepatitis B, C and HIV, and any condition contraindicating the study medication.
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学习计划
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
Rheumatoid arthritis patients
Participants in the original, parental trial
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There is no medical intervention.
The two groups are simple allocated depending on serum levels of D-total at the time of diagnosis
There is no medical intervention.
The two groups are simple allocated depending on serum levels of D-total at the time of diagnosis
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Cardiovascular event
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Events will be recorded using systematic journal audits.
A cardiovascular event will be further subclassified as shown in the secondary outcome measures, but for primary outcome measures; any cardiovascular event, including death, will serve as "an event"
|
Observed in the time-period from inclusion to October the 10th 2016
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Acute cardiovascular hospitalisation due to Myocardial Ischamia
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Non-fatal or fatal myocardial infarction, defined by National and International Guidelines (Thygesen et al. 1581-98). Fatal myocardial infarction is defined as primary fatal event within 7 days, documented post mortem by autopsy, or by the definition of myocardial infarction according to European Guidelines (Thygesen et al. 1581-98) Death of myocardial infarction as a consequence of medical examination/procedure/surgery will be classified as procedure related death. Acute Coronary Syndrome (ACS) includes acute ischaemic symptoms with eventual elevation in biomarkers or electrocardiographic changes which does not fulfil the criteria of acute myocardial infarction. Angina Pectoris. Revascularisation procedures (Percutaneous Coronary Intervention (PCI) or Coronary bypass Graft (CABG). |
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute cardiovascular hospitalisation due to hearth failure
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Patients with non-elective hospitalisation or death, minimum one overnight stay, with symptoms or findings of heart failure. Death due to heart failure is defined as escalating heart failure symptoms prior to death. |
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute cardiovascular hospitalisation due to stroke
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Cerebral haemorrhage, cerebral thromboembolism, Transitory Cerebral Ischemia (TCI) and others Stroke is defined as abrupt severe neurologic deficits, eventually with computer tomographic (CT) documentation.
Death within 14 days after symptom-onset of stroke, and without other obviously reasons, is classified as caused by stroke
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute cardiovascular hospitalisation due to arrhythmias
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Atrial fibrillation or flutter, supraventricular tachycardia and others.
Ventricular tachycardia, ventricular fibrillation and others.
Death due to arrhythmia requires documentation, e.g.
telemetric transcript, pacemaker or electrocardiogram
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute cardiovascular hospitalisation due to Procedure-related cardiovascular event
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Any cardiovascular event within 24 hours after cardiovascular medical examination/procedure/surgery.
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute cardiovascular hospitalisation due to other reasons
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Hospitalisation caused by other cardiovascular events, e.g.
pulmonary embolism, rupture of aortic aneurism etc.
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute cardiovascular hospitalisation due to supposed cardiovascular reason
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Hospitalisation without any documented non-cardiovascular cause. All deaths which are not defined by the cardiovascular reasons mentioned above, and who are not caused by well-documented non-cardiovascular death. All deaths without known reason |
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute non-cardiovascular hospitalisation due to cancer
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Acute hospitalisation due to cancer
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute non-cardiovascular hospitalisation due to infection
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Acute hospitalisation due to infection
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute non-cardiovascular hospitalisation due to respiratory disease
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Acute hospitalisation due to respiratory disease
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute non-cardiovascular hospitalisation due to trauma
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Acute hospitalisation due to trauma
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute non-cardiovascular hospitalisation due to suicide
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Acute - hospitalisation due to suicide
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Acute non-cardiovascular hospitalisation due to other reasons
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Acute hospitalisation du to other non-cardiovascular reasons, than those previous mentioned
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Elective cardiovascular hospitalisation due to myocardial ischemia
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective cardiovascular hospitalisation due to arrhythmia
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective cardiovascular hospitalisation due to heart failure
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective cardiovascular hospitalisation due to other cardiovascular reasons
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective non-cardiovascular hospitalisation due to cancer
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective non-cardiovascular hospitalisation due to infection
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective non-cardiovascular hospitalisation due to respiratory disease
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective non-cardiovascular hospitalisation due to trauma
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Elective non-cardiovascular hospitalisation due to suicide
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
|
Witnessed, sudden cardiovascular death
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Death is witnessed and abrupt within one hour after symptom-onset
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Non-witnessed, sudden cardiovascular death
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Non-witnessed death with no obvious non-cardiovascular reasons (found death)
|
Observed in the time-period from inclusion to October the 10th 2016
|
|
Non-sudden cardiovascular death
大体时间：Observed in the time-period from inclusion to October the 10th 2016
|
Death due to any of the cardiovascular caused previously mentioned, more than one hour after symptom-onset
|
Observed in the time-period from inclusion to October the 10th 2016
|
合作者和调查者
合作者
调查人员
- 学习椅：Torkell Ellingsen, MD, Phd、Odense University Hospital
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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