Ann Rheum Dis: Effects of rheumatoid arthritis on major cardiovascular events in patients with coronary heart disease and non-coronary heart disease
Last Update: 2020-06-16
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Rheumatoid arthritis (RA) is a risk factor for cardiovascular diseaseThe clinical outcomeof both RA and coronary heart disease (CAD) is not clearThe purpose of this study was to assess the effectof RA on the risk of adverse cardiovascular events in CAD or non-CAD patientsThis is a population-based cohort study that included patients who received coronary angiography (CAG) from 2003 to 2016 and were registered in the Western Danish Heart Register, stratified based on the presence of RA and CADThe endpoint seisfarcle (MI), major adverse cardiovascular events (MACE; MI; ischemic stroke and cardiac mortality) and total cause mortalityA total of 125331 patients were included (RA:n?1732)Median follow-up time is 5.2 yearsPatients with neither RA nor CAD were referred to (cumulative MI incidence 2.7%), only patients with RA (3.8%; adjusted incidence ratio (IRRadj) 1.63, 95% CI 1.04-2.54) and only CAD patients (9.9%; IRRadj 3.35, 95% CI 3.10-3.62) 10 years of MI risk, while patients with higher RA and IRRadrisk (22% 4.53,95% CI 3.66-5.59)Similar associations were observed for MACE and whole-cause mortalityIn patients receiving CAG, RA was significantly associated with a 10-year risk of MI, MACE, and all-cause mortality, regardless of CADHowever, patients with both RA and CAD are at the highest risk, and the additional risk of RA is low for patients without CADIn RA patients, risk stratification through the presence of CAD helps with screening and tailoring treatment strategies
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