TY - JOUR
T1 - High ten-year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients
T2 - A population-based cohort study
AU - Kremers, Hilal Maradit
AU - Crowson, Cynthia S.
AU - Therneau, Terry M.
AU - Roger, Veronique L.
AU - Gabriel, Sherine E.
PY - 2008/8
Y1 - 2008/8
N2 - Objective. To estimate the 10-year absolute risk of cardiovascular (CV) events in newly diagnosed rheumatoid arthritis (EIA) patients and the potential contribution of CV risk factors to absolute risk assessment. Methods. A population-based incidence cohort of RA patients (defined according to the American College of Rheumatology 1987 criteria) was assembled and compared with an age- and sex-matched non-RA cohort. Data were collected on CV risk factors and CV events. Cox regression models were used to estimate the 10-year risk of a combined CV end point, adjusting for CV risk factors. Subjects were classified into 5 risk categories based on their 10-year absolute risk. Results. The absolute CV risk in RA patients was similar to that in non-RA subjects who were 5-10 years older. The absolute risk varied substantially according to the presence of CV risk factors. The 10-year absolute CV risk among 60-69-year-old RA patients with no risk factors was 16.8%, but rose to 60.4% if risk factors such as smoking, hypertension, dyslipidemia, diabetes, and obesity were present. Among RA patients with a low body mass index, in addition to the above risk factors, the 10-year absolute CV risk rose to 86.2%. Conclusion. More than half of the newly diagnosed RA patients who were 50-59 years of age and all of those > 60 years of age had a > 10% risk of CV disease within 10 years of their RA incidence and should be targeted for specific CV risk reduction strategies tailored to their personal risk profiles.
AB - Objective. To estimate the 10-year absolute risk of cardiovascular (CV) events in newly diagnosed rheumatoid arthritis (EIA) patients and the potential contribution of CV risk factors to absolute risk assessment. Methods. A population-based incidence cohort of RA patients (defined according to the American College of Rheumatology 1987 criteria) was assembled and compared with an age- and sex-matched non-RA cohort. Data were collected on CV risk factors and CV events. Cox regression models were used to estimate the 10-year risk of a combined CV end point, adjusting for CV risk factors. Subjects were classified into 5 risk categories based on their 10-year absolute risk. Results. The absolute CV risk in RA patients was similar to that in non-RA subjects who were 5-10 years older. The absolute risk varied substantially according to the presence of CV risk factors. The 10-year absolute CV risk among 60-69-year-old RA patients with no risk factors was 16.8%, but rose to 60.4% if risk factors such as smoking, hypertension, dyslipidemia, diabetes, and obesity were present. Among RA patients with a low body mass index, in addition to the above risk factors, the 10-year absolute CV risk rose to 86.2%. Conclusion. More than half of the newly diagnosed RA patients who were 50-59 years of age and all of those > 60 years of age had a > 10% risk of CV disease within 10 years of their RA incidence and should be targeted for specific CV risk reduction strategies tailored to their personal risk profiles.
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U2 - 10.1002/art.23650
DO - 10.1002/art.23650
M3 - Article
C2 - 18668561
AN - SCOPUS:49449098214
SN - 0004-3591
VL - 58
SP - 2268
EP - 2274
JO - Arthritis and rheumatism
JF - Arthritis and rheumatism
IS - 8
ER -