Cardiovascular risk and mortality in rheumatoid arthritis compared with diabetes mellitus and the general population.
Rheumatology (Oxford)
; 60(3): 1400-1409, 2021 03 02.
Article
em En
| MEDLINE
| ID: mdl-32984893
ABSTRACT
OBJECTIVES:
To compare risk of cardiovascular disease and mortality in patients with incident RA, diabetes mellitus (DM) and the general population (GP).METHODS:
Patients diagnosed with incident RA were matched 15 by age, sex and year of RA diagnosis with the GP. In the same period, patients with incident DM were included. Outcomes were heart failure (HF), myocardial infarction (MI), coronary revascularization, stroke, major adverse cardiovascular events (MACE) and death up to 10 years after diagnosis.RESULTS:
We included 15 032 patients with incident RA, 301 246 patients with DM and 75 160 persons from the GP. RA patients had an increased risk of HF [hazard ratio (HR) 1.51, 95% CI 1.38, 1.64], MI (HR 1.58, 95% CI 1.43, 1.74), percutaneous coronary intervention (PCI; HR 1.44, 95% CI 1.27, 1.62), coronary artery bypass grafting (CABG; HR 1.30, 95% CI 1.05, 1.62) and stroke (HR 1.22, 95% CI 1.12-1.33) compared with the GP. However, the 10-year all-cause mortality was at the same level as observed in the GP. Cardiac death and MACE were increased in RA compared with the GP. When compared with patients with DM, RA patients had a lower adjusted risk of HF (HR 0.79, 95% CI 0.73, 0.85), CABG (HR 0.62, 95% CI 0.51, 0.76) and stroke (HR 0.82, 95% CI 0.76, 0.89), and similar risk of MI and PCI. DM patients had the highest risk of 10-year mortality, cardiac death and MACE.CONCLUSION:
This study demonstrates that RA is associated with an increased risk of HF, MI, stroke and coronary revascularization than found in the GP but without reaching the risk levels observed in DM patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Doenças Cardiovasculares
/
Complicações do Diabetes
/
Fatores de Risco de Doenças Cardíacas
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Rheumatology (Oxford)
Assunto da revista:
REUMATOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Dinamarca