Cardiovascular risk factors in patients with early rheumatoid arthritis

  • Nikiphorou E & al.
  • Heart
  • 24 Mar 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • People with newly diagnosed rheumatoid arthritis (RA) have an excess of stroke and heart failure at diagnosis and this appears to accumulate within the 5 years prior to diagnosis.

Why this matters

  • Findings highlight the importance of performing a cardiovascular disease (CVD) risk assessment at diagnosis and initiating early management of any identified CV risk factors.

Study design

  • Retrospective case-control study compared the prevalence of CVD and CVD risk factors at diagnosis between 6591 patients with newly diagnosed RA (cases) and 6591 age-and gender-matched controls.
  • Median follow-up: 5.4 years.
  • Funding: Pfizer.

Key results

  • RA vs control group had a significantly higher risk for stroke (3.9% vs 2.7%; P<.001 and heart failure vs p=".001)" but the risk for myocardial infarction was non-significant>
  • A greater number of CVD was reported in the 5 years preceding diagnosis in the RA vs control group (3.4% vs 2.8%; P=.036).
  • After adjustment for traditional and RA-related risk factors, the risk of post-diagnosis CVD was significantly greater in the RA vs control group (HR, 1.33; 95% CI, 1.07-1.65; P=.010).

Limitations

  • Retrospective design.
  • Risk of residual confounding.