Open AccessJournal Article
Cardiovascular risk factors and outcomes in early rheumatoid arthritis: a population-based study
Elena Nikiphorou,Simon de Lusignan,Christian D Mallen,Kaivan Khavandi,Gabriella Bedarida,Christopher D. Buckley,James Galloway,Karim Raza +7 more
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TLDR
An excess of stroke and heart failure occurs before diagnosis of RA and there is excess risk for further cardiovascular events after diagnosis, which is not explained by differences in traditional CVD or RA-related risk factors at diagnosis.Abstract:
Objective To assess the burden of cardiovascular disease (CVD) at and prior to diagnosis in people with early rheumatoid arthritis (RA) and subsequent CVD in these patients. Methods A retrospective case–control study using a large English primary care database. People with RA (n=6591) diagnosed between 2004 and 2016 (inclusive) were identified using a validated algorithm, matched 1:1 by age and gender to those without RA (n=6591) and followed for a median of 5.4 years. We assessed differences in CVD at, before and after diagnosis, and the impact of traditional and RA-related risk factors (C reactive protein, RA-related autoantibodies and medication use) on incident CVD (a composite of myocardial infarction (MI), stroke or heart failure). Results RA cases and their matched controls were both of mean age 58.7 (SD 15.5) at cohort entry, and 67.5% were female. Some CVD risk factors were more common at RA diagnosis including smoking and diabetes; however, total and low-density lipoprotein cholesterol were lower in patients with RA. CVD was more common in RA at cohort entry; stroke (3.9% vs 2.7%, p Conclusions An excess of stroke and heart failure occurs before diagnosis of RA. There is excess risk for further cardiovascular events after diagnosis, which is not explained by differences in traditional CVD or RA-related risk factors at diagnosis.read more
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Journal ArticleDOI
The mortality of rheumatoid arthritis
Frederick Wolfe,Donald M. Mitchell,John Sibley,James F. Fries,Daniel A. Bloch,Catherine A. Williams,Patricia W. Spitz,May Haga,S M Kleinheksel,M. A. Cathey +9 more
TL;DR: Mortality rates are increased at least 2-fold in RA, and are linked to clinical severity, with a large excess of deaths attributable to cardiovascular and cerebrovascular diseases.
Journal ArticleDOI
EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis
Mike J L Peters,Deborah P M Symmons,D McCarey,Ben A. C. Dijkmans,Paulo Nicola,Tore K Kvien,Iain B. McInnes,H Haentzschel,Miguel A. Gonzalez-Gay,Sella Aarrestad Provan,Anne Grete Semb,Prodromos Sidiropoulos,George D. Kitas,Yvo M. Smulders,Martin Soubrier,Zoltán Szekanecz,Naveed Sattar,Michael T. Nurmohamed +17 more
TL;DR: Ten recommendations were made for CV risk management in patients with rheumatoid arthritis, and the strength of the recommendations differed between RA on the one hand, and AS and PsA, on the other, as evidence for an increased CV risk is most compelling for RA.
Journal ArticleDOI
Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: A population-based cohort study
Hilal Maradit-Kremers,Cynthia S. Crowson,Paulo Nicola,Karla V. Ballman,Véronique L. Roger,Steve J. Jacobsen,Sherine E. Gabriel +6 more
TL;DR: Patients with RA have a significantly higher risk of CHD when compared with non-RA subjects, and RA patients are less likely to report symptoms of angina and more likely to experience unrecognized MI and sudden cardiac death.
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Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases
Sherine E. Gabriel,Kaleb Michaud +1 more
TL;DR: Strong evidence now shows that people with RA are at a high risk for developing several comorbid disorders, that these conditions may have atypical features and thus may be difficult to diagnose, and that persons with RA experience poorer outcomes after comorbridity compared with the general population.
Journal ArticleDOI
Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA)
Maxime Dougados,Martin Soubrier,Anna Antunez,Peter V. Balint,Alejandro Balsa,Maya H Buch,Maya H Buch,Gustavo Casado,Jacqueline Detert,Bassel Elzorkany,Paul Emery,Paul Emery,Najia Hajjaj-Hassouni,Masayoshi Harigai,Shue Fen Luo,Reka Kurucz,Gabriel Maciel,Emilio Martin Mola,Carlomaurizio Montecucco,Iain B. McInnes,Helga Radner,Josef S Smolen,Yeong Wook Song,Harald E. Vonkeman,Kevin L. Winthrop,Jonathan Kay +25 more
TL;DR: In this multinational sample of rheumatoid arthritis patients, variability among countries was wide, not only in prevalence but also in compliance with recommendations for preventing and managing these comorbidities.