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Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies

Annals of the rheumatic diseases, 2012-09, Vol.71 (9), p.1524-1529 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;2015 INIST-CNRS ;Copyright: 2012 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;ISSN: 0003-4967 ;EISSN: 1468-2060 ;DOI: 10.1136/annrheumdis-2011-200726 ;PMID: 22425941 ;CODEN: ARDIAO

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  • Title:
    Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies
  • Author: Avina-Zubieta, Juan Antonio ; Thomas, Jamie ; Sadatsafavi, Mohsen ; Lehman, Allen J ; Lacaille, Diane
  • Subjects: Arthritis, Rheumatoid - complications ; Biological and medical sciences ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Diseases of the osteoarticular system ; Health risk assessment ; Humans ; Inflammatory joint diseases ; Medical sciences ; Mortality ; Observation ; Rheumatoid arthritis ; Risk Factors ; Studies
  • Is Part Of: Annals of the rheumatic diseases, 2012-09, Vol.71 (9), p.1524-1529
  • Description: Objective To determine the magnitude of the risk of incident cardiovascular disease (CVD; fatal and non-fatal), including acute myocardial infarction (MI), cerebrovascular accidents (CVA) and congestive heart failure (CHF), in patients with rheumatoid arthritis (RA) compared to the general population through a meta-analysis of controlled observational studies. Methods The authors searched the Medline, Embase, LILACS and Cochrane databases from their inception to June 2011. Observational studies meeting the following criteria were included: (1) prespecified RA criteria; (2) predefined CVD criteria for incident CVD (MI, CVA or CHF); (3) a comparison group; and (4) RR estimates, 95% CI or data for calculating them. The authors calculated the pooled RR using the random-effects model and tested for heterogeneity using the bootstrap version of the Q statistic. Results Fourteen studies comprising 41 490 patients met the inclusion criteria. Overall, there was a 48% increased risk of incident CVD in patients with RA (pooled RR 1.48 (95% CI 1.36 to 1.62)). The risks of MI and CVA were increased by 68% (pooled RR 1.68 (95% CI 1.40 to 2.03)) and 41% (pooled RR 1.41 (95% CI 1.14 to 1.74)). The risk of CHF was assessed in only one study (RR 1.87 (95% CI 1.47 to 2.39)). Significant heterogeneity existed in all main analyses. Subgroup analyses showed that inception cohort studies were the only group that did not show a significantly increased risk of CVD (pooled RR 1.12 (95% CI 0.97 to 1.65)). Conclusions Published data indicate that the risk of incident CVD is increased by 48% in patients with RA compared to the general population. Sample and cohort type influenced the estimates of RR.
  • Publisher: London: BMJ Publishing Group Ltd and European League Against Rheumatism
  • Language: English
  • Identifier: ISSN: 0003-4967
    EISSN: 1468-2060
    DOI: 10.1136/annrheumdis-2011-200726
    PMID: 22425941
    CODEN: ARDIAO
  • Source: MEDLINE
    Alma/SFX Local Collection
    ProQuest Central
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