Meta-analysis bolsters link between rheumatic and cardiovascular disease
medwireNews: Both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are associated with an increased risk for symptomatic cardiovascular (CV) events but data are lacking for asymptomatic events, results of a systematic review and meta-analysis show.
The review, by Vincenzo Restivo (University of Palermo, Italy) and co-authors, included seven studies, each with at least 5 years of follow-up, that examined symptomatic CV risk in people with SLE, plus four studies examining the same outcome in people with RA, and two studies that included individuals with either rheumatic disease.
The investigators identified just one study that looked at asymptomatic CV events such as echocardiographic alterations due to myocardial ischemia, which involved people with SLE.
As reported in Autoimmunity Reviews, the meta-analysis showed that the risk for symptomatic CV events (myocardial ischemia, stroke, or peripheral artery disease) was a significant 1.98 times higher in people with versus without SLE.
This “emphasises the importance of a comprehensive and not a strictly pathology-limited assessment of the patients affected by a chronic inflammatory disease, such as SLE,” the researchers remark.
They add that “assessment of cardiovascular risk factors represents a central objective in the diagnostic framework and clinical monitoring of the disease nowadays and is an essential criterion of therapeutic choice.”
Subgroup analyses revealed that the relative risk (RR) for CV events among people with versus without SLE was higher among those younger than 46 years of age, at 2.21, than for older individuals, at 1.89.
Restivo and colleagues also found that individuals with RA had a significant 1.55-fold higher risk for symptomatic CV events than people without the condition. In this group, the RR was 1.98 among individuals younger than 60 years of age and 1.43 among older individuals.
In both groups of patients, there was a lower risk for CV events in studies carried out in North America relative to those conducted in Europe or Asia and there was a higher CV incidence in studies conducted after 2000 compared with earlier studies.
The authors conclude that their “data are helpful to implement cardiovascular preventive strategies among people suffering from rheumatologic diseases to decrease the incidence of cardiovascular events.”
They add: “These implementations need to [involve collaboration] between rheumatologists and primary care healthcare workers to furnish the same information to patients and monitor their preventive practice compliance.”
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