TY - JOUR

T1 - Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis

AU - Crowson, Cynthia

AU - Rollefstad, Silvia

AU - Ikdahl, Elrik

AU - Kitas, George D.

AU - van Riel, Piet L.C.M.

AU - Gabriel, Sherine E.

AU - Matteson, Erik L.

AU - Kvien, Tore K.

AU - Doughlas, Karen

AU - Sandoo, Aamer

AU - Arts, Elke

AU - Wållberg-Jonsson, Solveig

AU - Innala, Lena

AU - Karpouzas, George

AU - Dessein, Patrick

AU - Tsang, Linda

AU - El-Gabalawy, Hani

AU - Hitchon, Carol

AU - Pascual Ramos, Virginia

AU - Contreras Yáñez, Irazu

AU - Sfikakis, Petros P.

AU - Zampeli, Evangelia

AU - Gonzalex-Gay, Miguel A.

AU - Corrales, Alfonso

AU - van der Laar, Mart

AU - Vonkeman, Harold E.

AU - Meek, Inge

AU - Semb, Anne Grete

PY - 2018/1

Y1 - 2018/1

N2 - 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.

AB - 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.

U2 - 10.1136/annrheumdis-2017-211735

DO - 10.1136/annrheumdis-2017-211735

M3 - Article

VL - 77

SP - 48

EP - 54

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 1

ER -