Risk of major adverse cardiovascular events among patients with rheumatoid arthritis after initial CT-based diagnosis and treatment

被引:11
作者
de Thurah, Annette [1 ,2 ]
Andersen, Ina Trolle [3 ]
Tinggaard, Andreas Bugge [4 ]
Riis, Anders Hammerich [3 ]
Therkildsen, Josephine [4 ]
Botker, Hans Erik [2 ,5 ]
Bottcher, Morthen [4 ]
Hauge, Ellen-Margrethe [1 ,2 ]
机构
[1] Aarhus Univ Hosp Skejby, Dept Rheumatol, Aarhus N, Denmark
[2] Aarhus Univ, Dept Clin Med, Aarhus N, Denmark
[3] Aarhus Univ Hosp Skejby, Dept Clin Epidemiol, Aarhus N, Denmark
[4] Hosp Unit West, Dept Cardiol, Herning, Denmark
[5] Aarhus Univ Hosp Skejby, Dept Cardiol, Aarhus N, Denmark
关键词
COMPOSITE END-POINTS; DISEASE-ACTIVITY; RECOMMENDATIONS; METAANALYSIS; PERFORMANCE; VALIDATION; MORTALITY; REGISTER; SCORE;
D O I
10.1136/rmdopen-2019-001113
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Rheumatoid arthritis (RA) is a known risk factor for developing coronary artery disease (CAD). The influence of RA on the prognosis after initial CAD diagnosis and treatment is however largely unknown. We examined the risk of major cardiovascular events among RA and non-RA patients with chest pain referred to cardiac CT. Methods This was a follow-up study, using data from the Western Denmark Heart Registry, containing data on CT angiography examinations (Cardiac CT). Information on RA diagnosis and covariates were identified through nationwide administrative registers. The primary outcome was a combined outcome including, myocardial infarction, ischaemic or unspecified stroke, coronary artery bypass grafting, percutaneous coronary intervention, and all-cause mortality. Median time until events or censoring was 3.5 years (min/max: 0.0: 9.2). Cox proportional hazard models were used to examine the association between RA/non-RA patients and outcomes. Results Among 42 257 patients, referred between 2008 and 2016, we identified 358 (0.8%) with RA. An increased risk was seen in RA compared with non-RA (adjusted HR 1.35, 95% CI 0.93 to 1.96). Among patients who had received flare treatment more than once prior to cardiac CT the adjusted HR 1.80 (95% CI 1.08 to 3.00), and among patients with seropositive RA the adjusted HR 1.42 (95% CI 0.93 to 2.16). Conclusion In patients referred to cardiac CT due to chest pain, we found a trend of an association between RA and the combined primary outcome, supporting that RA per se, but in particular seropositive and active RA, may increase the risk of CAD even after initial CAD diagnosis and treatment.
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页数:10
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