Strong Association Between Active RA and Cardiovascular Events After Initial Diagnosis

RA is associated with an increased risk for cardiovascular disease and mortality.

The following article is part of conference coverage from the 2018 American College of Rheumatology and Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in Chicago, Illinois. Rheumatology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in rheumatology. Check back for the latest news from ACR/ARHP 2018 .

CHICAGO—There may be a significant link between active rheumatoid arthritis (RA) and major cardiovascular events (MACE) in individuals at risk for coronary artery disease (CAD). This link is particularly significant in those with seropositive RA and inflammation, according to a recent study presented at the 2018 ACR/ARHP Annual Meeting, held October 19 to 24, 2018, in Chicago, Illinois.

In this follow-up study, researchers culled 42,257 individuals from the Western Denmark Heart Registry and identified 358 as having RA. Researchers relied on Cox proportional hazard models to study the relationship between patients with RA and those who did not have RA, including outcomes.

The rate for revascularization—without original diagnosis association—was 3.4 (95% CI, 1.3-9.0)/1000 person-years in individuals with RA and 3.7 (95% CI, 3.7-4.1)/1000 person-years in those who did not have RA. For combined outcome (CO) and MACE, people with RA demonstrated an increased risk compared with those who did not have RA—(CO hazard ratio [HR], 1.35; 95% CI, 0.93-1.96), MACE: HR, 1.94 (95% CI, 1.18-3.19), respectively.

The risk was higher among individuals who had received intramuscular glucocorticoid injections more than once within 3 years prior to a CT scan (CO HR, 1.80; 95% CI, 1.1-3.0), MACE, HR 3.02; 95% CI, 1.62-5.65) and in individuals with seropositive RA (CO HR, 1.42; 95% CI, 0.93-2.16), MACE: HR, 2.45; 95% CI, 1.47-4.08).

In closing, the researchers noted, “a strong association between RA and cardiovascular events in the period after the initial diagnosis and treatment in this cohort of patients with a-priori risk of CAD referred for cardiac CT.”

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Their findings suggest that RA is associated with an increased risk for cardiovascular disease and mortality.

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de Thurah A, Andersen IT, Tingaard AB, et al. Excessive risk of major cardiovascular events in seropositive rheumatoid arthritis and in patients with active disease. Presented at: 2018 ACR/ARHP Annual Meeting; October 19-24, 2018; Chicago, IL. Abstract 213.

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