Excess cardiovascular risk in RA patients may be on the decline
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medwireNews: Meta-analysis findings have confirmed an excess risk for cardiovascular events in patients with rheumatoid arthritis (RA), but also show that this excess risk has declined since the year 2000.
Across 28 studies involving 227,871 patients with RA, aged an average of 55 years, the relative risks for myocardial infarction, stroke, congestive heart failure, and cardiovascular mortality were a significant 1.24, 1.17, 1.18, 1.22, and 1.18, respectively, compared with controls.
However, when the risk was compared between studies published before and after the year 2000, the researchers found that the excess risk for myocardial infarction had reduced after this timepoint, while the risk for stroke remained stable, and there was no longer an excess risk for congestive heart failure or cardiovascular mortality.
The relative risk for myocardial infarction fell from 1.32 before 2000 to 1.18 after 2000, while the risk for stroke remained similar at 1.12 and 1.23, respectively.
For congestive heart failure and cardiovascular mortality, there was a decrease from a significant relative risk of 1.25 and 1.21 before 2000 to a nonsignificant 1.17 and 1.07 for subsequent years.
While improved management of cardiovascular risk may be one explanation, senior author Cécile Gaujoux-Viala, from the University of Montpellier in France, says that the findings may also be related to better control of systemic inflammation by new therapeutic strategies.
“Over the past 15 years, new treatment strategies such as tight control, treat to target, methotrexate optimization, and the use of biologic DMARDs [disease-modifying antirheumatic drugs] has allowed a better control of systemic inflammation in patients with RA,” she highlighted to the press at the Annual European Congress of Rheumatology (EULAR) 2017.
By Lucy Piper
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