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Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis

Annals of the rheumatic diseases, 2018-01, Vol.77 (1), p.48-54 [Peer Reviewed Journal]

Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. ;2018 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. ;ISSN: 0003-4967 ;ISSN: 1468-2060 ;EISSN: 1468-2060 ;DOI: 10.1136/annrheumdis-2017-211735 ;PMID: 28877868

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Title:
Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis
Author: Crowson, Cynthia S ; Rollefstad, Silvia ; Ikdahl, Eirik ; Kitas, George D ; van Riel, Piet L C M ; Gabriel, Sherine E ; Matteson, Eric L ; Kvien, Tore K ; Douglas, Karen ; Sandoo, Aamer ; Arts, Elke ; Wållberg-Jonsson, Solveig ; Innala, Lena ; Karpouzas, George ; Dessein, Patrick H ; Tsang, Linda ; El-Gabalawy, Hani ; Hitchon, Carol ; Ramos, Virginia Pascual ; Yáñez, Irazú Contreras ; Sfikakis, Petros P ; Zampeli, Evangelia ; Gonzalez-Gay, Miguel A ; Corrales, Alfonso ; Laar, Mart van de ; Vonkeman, Harald E ; Meek, Inger ; Semb, Anne Grete
Subjects: Adult ; Aged ; Angina ; Arthritis, Rheumatoid - complications ; Blood pressure ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cerebral infarction ; Cholesterol ; Cholesterol - blood ; Cohort Studies ; Female ; Follow-Up Studies ; Gender differences ; Health risk assessment ; Humans ; Hypertension - epidemiology ; Hypertension - etiology ; Incidence ; Lipids ; Male ; Middle Aged ; Myocardial infarction ; Rheumatoid arthritis ; Risk Factors ; Severity of Illness Index ; Sex differences ; Sex Factors ; Smoking ; Smoking - adverse effects ; Smoking - epidemiology ; Vascular diseases
Is Part Of: Annals of the rheumatic diseases, 2018-01, Vol.77 (1), p.48-54
Description: ObjectivesPatients 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.MethodsIn 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.Results5638 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).ConclusionsIn 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.
Publisher: England: BMJ Publishing Group LTD
Language: English
Identifier: ISSN: 0003-4967
ISSN: 1468-2060
EISSN: 1468-2060
DOI: 10.1136/annrheumdis-2017-211735
PMID: 28877868
Source: MEDLINE
ProQuest Central

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Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis

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