RESEARCH - Patterns of cardiovascular risk in RA

June 28, 2006

Ann Rheum Dis. 2006 Jun 22; [Epub ahead of print]

Patterns of cardiovascular risk In rheumatoid arthritis.

DH, Goodson NJ, Katz JN, Weinblatt ME, Avorn J, Setoguchi S, Canning

C, Schneeweiss S.

Brigham and Women's Hospital, United States.

BACKGROUND: While it is known that RA is associated with an increased risk

of cardiovascular disease (CVD), the pattern of this risk is not clear. We

investigated the relative risk of myocardial infarction (MI), stroke, and

CVD mortality in adults with RA compared with adults without RA across age

groups, gender, and prior CVD event status. METHODS: We conducted a cohort

study among all residents (3) 18 years of age residing in British Columbia

between 1999 and 2003. Residents who had at least 3 physician visits for RA

(ICD = 714) were considered to have RA. A non-RA cohort was matched to the

RA cohort by age, gender, and start of follow-up. The primary composite

endpoint was a hospital admission for either MI or stroke or CVD mortality.

RESULTS: We identified 25,385 subjects who had at least three diagnoses for

RA during the study period. During the 5-year study period, 375 patients

with RA had a hospital admission for an MI, 363 had a hospitalization for a

stroke, 437 died from cardiovascular causes, and 1,042 had one of these

outcomes. The rate ratio for a CVD event in subjects with RA was 1.6 (95% CI

1.5 - 1.7), and the rate difference 5.7 (95% CI 4.9 - 6.4) per 1,000 person-

years. The rate ratio decreased with age, from 3.3 in persons 18 - 39 years

of age to 1.6 in those 75 and over. However, the rate difference was 1.2 per

1,000 person-years in the youngest age group and increased to 19.7 per 1,000

person-years in those 75 and over. Among subjects with a prior CVD event,

the rate ratios and rate differences were not elevated in RA.

CONCLUSIONS: This study confirms that RA is a risk factor for CVD events and

demonstrates that the rate ratio for CVD events among persons with RA is

highest in young adults and those without known prior CVD events. However,

in absolute terms, the difference in event rates is highest in older adults.

PMID: 16793844

6793844 & dopt=Abstract

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

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