Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis. Issue 1 (6th September 2017)

• Record Type: Journal Article
• Authors: Crowson, Cynthia S; Rollefstad, Silvia; Ikdahl, Eirik; Kitas, George D; van Riel, Piet L C M; Gabriel, Sherine E; Matteson, Eric L; Kvien, Tore K; Douglas, Karen; Sandoo, Aamer; Arts, Elke; Wållberg-Jonsson, Solveig; Innala, Lena; Karpouzas, George; Dessein, Patrick H; Tsang, Linda; El-Gabalawy, Hani; Hitchon, Carol; Ramos, Virginia Pascual; Yáñez, Irazú Contreras; Sfikakis, Petros P; Zampeli, Evangelia; Gonzalez-Gay, Miguel A; Corrales, Alfonso; Laar, Mart van de; Vonkeman, Harald E; Meek, Inger; Semb, Anne Grete
• Other Names: author non-byline.; Colunga Iris author non-byline.; Galarza Dionicio author non-byline.; Azpiri-lópez José Ramón author non-byline.; Husni Elaine author non-byline.; Overman Robert author non-byline.; Fransen Jaap author non-byline.; Rantapää-dahlqvist Solbritt author non-byline.; Solomon Daniel author non-byline.; Liao Katherine author non-byline.
• Is Part Of: Annals of the rheumatic diseases. Volume 77:Issue 1(2018)
• Page Start: 48
• Page End: 54
• Publication Date: 2017-09-06
• Subjects: Cardiovascular disease -- rheumatoid arthritis -- risk factor -- population attributable risk; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2017-211735
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: Patients with rheumatoid arthritis (RA) have an excess risk of cardiovascular disease (CVD). We aimed to assess the impact of CVD risk factors, including potential sex differences, and RA-specific variables on CVD outcome in a large, international cohort of patients with RA. Methods: In 13 rheumatology centres, data on CVD risk factors and RA characteristics were collected at baseline. CVD outcomes (myocardial infarction, angina, revascularisation, stroke, peripheral vascular disease and CVD death) were collected using standardised definitions. Results: 5638 patients with RA and no prior CVD were included (mean age: 55.3 (SD: 14.0) years, 76% women). During mean follow-up of 5.8 (SD: 4.4) years, 148 men and 241 women developed a CVD event (10-year cumulative incidence 20.9% and 11.1%, respectively). Men had a higher burden of CVD risk factors, including increased blood pressure, higher total cholesterol and smoking prevalence than women (all p<0.001). Among the traditional CVD risk factors, smoking and hypertension had the highest population attributable risk (PAR) overall and among both sexes, followed by total cholesterol. The PAR for Disease Activity Score and for seropositivity were comparable in magnitude to the PAR for lipids. A total of 70% of CVD events were attributable to all CVD risk factors and RA characteristics combined (separately 49% CVD risk factors and 30% RA characteristics). Conclusions: In a large, international cohort of patients with RA, 30% of CVD events were attributable to RA characteristics. This finding indicates that RA characteristics play an important role in efforts to reduce CVD risk among patients with RA.