• Cynthia Crowson
    Mayo Clinic, Rochester, MN
  • Silvia Rollefstad
    Oslo University Hospital
  • Elrik Ikdahl
    Oslo University Hospital
  • George D. Kitas
    NHS Foundation Trust, West Midlands
  • Piet L.C.M. van Riel
    Radboud University Nijmegen
  • Sherine E. Gabriel
    Mayo Clinic, Rochester, MN
  • Erik L. Matteson
    Mayo Clinic, Rochester, MN
  • Tore K. Kvien
    Oslo University Hospital
  • Karen Doughlas
    NHS Foundation Trust, West Midlands
  • Aamer Sandoo
  • Elke Arts
    Radboud University Nijmegen
  • Solveig Wållberg-Jonsson
    Umea University
  • Lena Innala
    Umea University
  • George Karpouzas
    UCLA Medical Center, Torrance, CA
  • Patrick Dessein
    University of the Witwatersrand, South Africa
  • Linda Tsang
    Vrije Universiteit Brussels
  • Hani El-Gabalawy
    University of Manitoba, Winnipeg
  • Carol Hitchon
    University of Manitoba, Winnipeg
  • Virginia Pascual Ramos
    Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City
  • Irazu Contreras Yáñez
    Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City
  • Petros P. Sfikakis
    University of Athens
  • Evangelia Zampeli
    University of Athens
  • Miguel A. Gonzalex-Gay
    Hospital Universitario Marques de Valdecilla, Santander
  • Alfonso Corrales
    Hospital Universitario Marques de Valdecilla, Santander
  • Mart van der Laar
    Hospital Medisch Spectrum Twente, Enschede
  • Harold E. Vonkeman
    Hospital Medisch Spectrum Twente, Enschede
  • Inge Meek
    Hospital Medisch Spectrum Twente, Enschede
  • Anne Grete Semb
    Oslo University Hospital
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.
Original languageEnglish
Pages (from-to)48-54
JournalAnnals of the Rheumatic Diseases
Volume77
Issue number1
Early online date11 Dec 2017
DOIs
Publication statusPublished - Jan 2018

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