TY - JOUR
T1 - Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis
AU - Crowson, Cynthia S.
AU - Rollefstad, Silvia
AU - Ikdahl, Eirik
AU - Kitas, George D.
AU - Van Riel, Piet L.C.M.
AU - Gabriel, Sherine E.
AU - Matteson, Eric L.
AU - Kvien, Tore K.
AU - Douglas, Karen
AU - Sandoo, Aamer
AU - Arts, Elke
AU - Wållberg-Jonsson, Solveig
AU - Innala, Lena
AU - Karpouzas, George
AU - Dessein, Patrick H.
AU - Tsang, Linda
AU - El-Gabalawy, Hani
AU - Hitchon, Carol
AU - Ramos, Virginia Pascual
AU - Yáñez, Irazä Contreras
AU - Sfkakis, Petros P.
AU - Zampeli, Evangelia
AU - Gonzalez-Gay, Miguel A.
AU - Corrales, Alfonso
AU - Van De Laar, Mart
AU - Vonkeman, Harald E.
AU - Meek, Inger
AU - Semb, Anne Grete
N1 - Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - Objectives P atients 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 P atients 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.
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U2 - 10.1136/annrheumdis-2017-211735
DO - 10.1136/annrheumdis-2017-211735
M3 - Article
C2 - 28877868
AN - SCOPUS:85038236789
SN - 0003-4967
VL - 77
SP - 48
EP - 54
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 1
ER -