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Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no 1, p. 48-54Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018. Vol. 77, no 1, p. 48-54
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:umu:diva-143710DOI: 10.1136/annrheumdis-2017-211735ISI: 000417778700012PubMedID: 28877868OAI: oai:DiVA.org:umu-143710DiVA, id: diva2:1171827
Available from: 2018-01-08 Created: 2018-01-08 Last updated: 2018-06-09Bibliographically approved

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Wållberg-Jonsson, SolveigInnala, Lena

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