Ami Schattner, MD
In patients with rheumatoid arthritis (RA), what is the 10-year absolute risk for cardiovascular (CV) events? How do CV risk factors affect absolute risk?
Inception cohort followed for median 15 years.
Rochester Epidemiology Project medical records linkage system in Olmsted County, Minnesota, USA.
553 adults ≥ 18 years of age (mean age 57 y, 73% women) who had RA (4 of 7 American College of Rheumatology 1987 criteria) and were newly diagnosed between 1955 and 1994. For comparison, 574 adults without RA, matched for sex, year of birth, and length of medical history, were randomly selected from the same record system. Patients with a history of CV disease at baseline were excluded.
Traditional CV risk factors (cigarette smoking, dyslipidemia, diabetes mellitus, hypertension, and obesity [body mass index ≥ 30 kg/m2]) and low body mass index (< 20 kg/m2).
Composite of coronary revascularization procedure (including percutaneous transluminal coronary angioplasty and coronary artery bypass graft), silent or nonfatal myocardial infarction, congestive heart failure, or CV death.
46% of patients with RA and 36% of those without RA had a first CV event during follow-up. Patients with RA were more likely to have been current or former smokers at baseline (52% vs 43%, P = 0.004). Absolute 10-year CV risk varied with age and was 10% to 56% in those with RA and 2% to 37% in those without RA (Table). For patients with RA and 5 traditional CV risk factors, 10-year CV risk was 2 to 5 times higher than for those with RA and no risk factors (Table).
In patients with rheumatoid arthritis, absolute 10-year risk for cardiovascular events was 10% to 56%; risk for those with 5 traditional cardiovascular risk factors was 14% to 90%.
Absolute 10-year risk for cardiovascular (CV) events* in adults with and without rheumatoid arthritis (RA)
*Composite of coronary revascularization procedure, silent or nonfatal myocardial infarction, congestive heart failure, or CV death.
†Number of patients per group provided by author.
‡Extrapolated from figure 1B in original article and confirmed by author.
§Current or former smoker, hypertension, dyslipidemia, diabetes mellitus, and obesity (body mass index ≥ 30 kg/m2).
Schattner A. 10-year risk for CV events was 10% to 56% in rheumatoid arthritis; risk was greatest for patients with CV risk factors. Ann Intern Med. ;149:JC5–14. doi: 10.7326/0003-4819-149-10-200811180-02014
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Published: Ann Intern Med. 2008;149(10):JC5-14.
Cardiology, Coronary Risk Factors, Prevention/Screening, Rheumatoid Arthritis, Rheumatology.
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