RESEARCH - Depressed patients with RA at risk for MI

[Guest guest]

Depressed Patients With Rheumatoid Arthritis at Risk for MI

Jayashri Sankaranarayanan, MPharm, PhD

Posted: 26 Apr 2010

Study Summary

Scherrer and colleagues studied a retrospective cohort of 15,634

patients (93% men and 7% women) who had rheumatoid arthritis (RA; ages

30-79 years). The patients were drawn from the Department of Veterans

Affairs (VA) national administrative and pharmacy databases between

1999 and 2006, and they all had a record of using a disease-modifying

antirheumatic drug.

Patients were free of cardiovascular disease for 2 years before any

diagnosis of RA or depression. The authors classified patients with RA

as " depressed " if they had made 2 or more visits for a depression

diagnosis following RA diagnosis, but before the onset of an

outpatient or inpatient ICD-9-CM code for myocardial infarction (MI).

Therefore, the effect of depression was expected to be an independent

predictor of MI in a maximum 6-year follow-up period. Analyses were

adjusted for patient sociodemographic characteristics (age, gender,

race, insurance, and marital status) and known MI risk factors (eg,

posttraumatic stress disorder, obesity, hyperlipidemia, hypertension,

diabetes, tobacco dependence).

Depressed patients with RA without a history of cardiovascular disease

were 40% more likely to have a MI compared with those without

depression. Age and risk factors (ie, diabetes, hypertension,

hyperlipidemia) excluding obesity were significant risk factors for

MI. RA disease severity (based on the number of orthopaedic surgeries

and the number of intra-articular injections) was also predictive of

MI.

*****************************************************

Read the entire article here:

http://www.medscape.com/viewarticle/720538

Not an MD