Impact of rheumatoid arthritis on major cardiovascular events in patients with and without coronary artery disease
Brian Bridal Løgstrup,Kevin Kris Warnakula Olesen,Dzenan Masic,Christine Gyldenkerne,Pernille Gro Thrane,Torkell Ellingsen,Hans Erik Bøtker,Michael Maeng +7 more
TLDR
In patients undergoing CAG, RA is significantly associated with the 10-year risk of MI, MACE and all-cause mortality regardless of the presence of CAD, however, patients with RA and CAD carry the largest risk, while the additive risk of RA in patients without CAD is minor.Abstract:
Introduction Rheumatoid arthritis (RA) is a risk factor for cardiovascular disease. The clinical consequences of coincident RA and coronary artery disease (CAD) are unknown. Objective We aimed to estimate the impact of RA on the risk of adverse cardiovascular events in patients with and without CAD. Methods A population-based cohort of patients registered in the Western Denmark Heart Registry, who underwent coronary angiography (CAG) between 2003 and 2016, was stratified according to the presence of RA and CAD. Endpoints were myocardial infarction (MI), major adverse cardiovascular events (MACE; MI, ischaemic stroke and cardiac death) and all-cause mortality. Results A total of 125 331 patients were included (RA: n=1732). Median follow-up was 5.2 years. Using patients with neither RA nor CAD as reference (cumulative MI incidence 2.7%), the 10-year risk of MI was increased for patients with RA alone (3.8%; adjusted incidence rate ratio (IRRadj) 1.63, 95% CI 1.04 to 2.54), for patients with CAD alone (9.9%; IRRadj 3.35, 95% CI 3.10 to 3.62), and highest for patients with both RA and CAD (12.2%; IRRadj 4.53, 95% CI 3.66 to 5.59). Similar associations were observed for MACE an all-cause mortality. Conclusions In patients undergoing CAG, RA is significantly associated with the 10-year risk of MI, MACE and all-cause mortality regardless of the presence of CAD. However, patients with RA and CAD carry the largest risk, while the additive risk of RA in patients without CAD is minor. Among patients with RA, risk stratification by presence or absence of documented CAD may allow for screening and personalised treatment strategiesread more
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The key comorbidities in patients with rheumatoid arthritis: A narrative review
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Patterns of multimorbidity and their effects on adverse outcomes in rheumatoid arthritis: a study of 5658 UK Biobank participants
Ross McQueenie,Barbara I. Nicholl,Bhautesh Dinesh Jani,Jordan Canning,Sara Macdonald,Colin McCowan,Joanne Neary,Susan Browne,Frances S. Mair,Stefan Siebert +9 more
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References
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Journal ArticleDOI
Biologics and cardiovascular events in inflammatory arthritis: a prospective national cohort study.
Joshua L. Lee,Premarani Sinnathurai,Premarani Sinnathurai,Premarani Sinnathurai,Rachelle Buchbinder,Christopher Hill,Marissa Lassere,Marissa Lassere,Lyn March,Lyn March,Lyn March +10 more
TL;DR: Current biologic use was associated with a reduction in major CVEs and no reduction was seen in those who had ceased biologic therapy, while after adjustment, the CVE risk was not significantly different between RA, AS or PsA.
Journal ArticleDOI
Brief Report: The Ability of the 2013 American College of Cardiology/American Heart Association Cardiovascular Risk Score to Identify Rheumatoid Arthritis Patients With High Coronary Artery Calcification Scores
TL;DR: The hypothesis that the 2013 American College of Cardiology/American Heart Association 10‐year risk score would perform better than the FRS and the Reynolds Risk Score in identifying RA patients known to have elevated cardiovascular risk based on high coronary artery calcification (CAC) scores is tested.
Journal ArticleDOI
Validity and completeness of rheumatoid arthritis diagnoses in the nationwide DANBIO clinical register and the Danish National Patient Registry.
Else Helene Ibfelt,Jan Sørensen,Jan Sørensen,Dorte Vendelbo Jensen,Dorte Vendelbo Jensen,Lene Dreyer,Lene Dreyer,Berit Schiøttz-Christensen,Pia H Thygesen,Ada Colic,Johnny Lillelund Raun,Natalia Manilo,Anne Rødgaard,Uta Engling Poulsen,Claus Rasmussen,Torben Hansen,Babara Unger,R. Pelck,Anita Kincses,Henrik Nordin,Tove Lorenzen,Ali Theibich,Inger Marie Jensen Hansen,Jakob Espesen,Jolanta Grydehøj,Mette Holland-Fischer,Anne Gitte Loft,Merete Lund Hetland,Merete Lund Hetland +28 more
TL;DR: DANBIO held a high proportion of true RA cases (96%) and was found to be superior to the DNPR with regard to the validity of the diagnosis, and both registries were estimated to have a high completeness of RA cases treated in hospital care.
Journal ArticleDOI
Challenges of developing a cardiovascular risk calculator for patients with rheumatoid arthritis.
Cynthia S. Crowson,Silvia Rollefstad,George D. Kitas,Piet L. C. M. van Riel,Sherine E. Gabriel,Anne Grete Semb +5 more
TL;DR: Efforts to develop a specific CVD risk calculator for patients with RA yielded 2 potential models including RA disease characteristics, but neither demonstrated improved performance compared to risk calculators designed for use in the general population.
Journal ArticleDOI
Outcomes of percutaneous coronary intervention in patients with rheumatoid arthritis and systemic lupus erythematosus: an 11-year nationwide cohort study
Chao Han Lai,Wu Wei Lai,Meng Jiun Chiou,Wei Chieh Lin,Yu Jen Yang,Chung Yi Li,Liang Miin Tsai +6 more
TL;DR: This study recognises the inherent risks associated with RA and SLE in patients undergoing PCI and highlights the necessity to improve the caring and secondary prevention strategies for these high-risk patients.
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