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25-04-2018 | Rheumatoid arthritis | Article

Prevalence of cardiovascular disease and major risk factors in patients with rheumatoid arthritis: a multinational cross-sectional study

Journal: Clinical Rheumatology

Authors: Dimitrios A. Pappas, Fredrik Nyberg, Joel M. Kremer, Kathy Lampl, George W. Reed, Laura Horne, Meilien Ho, Alina Onofrei, Anand N. Malaviya, Oscar L. Rillo, Sebastiao C. Radominski, Janos Gal, Allan Gibofsky, Tatiana V. Popkova, Leda Laurindo, Eduardo M. Kerzberg, Roman Zahora, Bernado A. Pons-Estel, Jeffrey R. Curtis, Daniel E. Furst, Jeffrey D. Greenberg

Publisher: Springer London

Abstract

To compare the prevalence of cardiovascular disease (CVD) and major CVD risk factors among rheumatoid arthritis (RA) patients enrolled in a large US and multinational registry. We compared CVD and CVD risk factor prevalence from 11 countries enrolled in the CORRONA US and CORRONA International registries; patients from the 10 ex-US participating countries were grouped by region (Eastern Europe, Latin America, and India). Unadjusted summary data were presented for demographics and disease characteristics; comparisons for prevalence of CVD risk factors and CVD were age/gender standardized to the age/gender distribution of the US enrolled patients. Overall, 25,987 patients were included in this analysis. Compared to patients from the ex-US regions, US participants had longer disease duration and lower disease activity, yet were more likely to receive a biologic agent. Additionally, CORRONA US participants had the highest body mass index (BMI). Enrolled patients in India had the lowest BMI, were more rarely smokers, and had a low prevalence of hyperlipidemia, hypertension, and prior CVD compared to the US and other ex-US regions. Participants from Eastern Europe had a higher prevalence of hypertension and hyperlipidemia and highest prevalence of all manifestations of CVD. Differences in the prevalence of both CVD and major CVD risk factors were observed across the four regions investigated. Observed differences may be influenced by variations in both non-modifiable/modifiable characteristics of patient populations, and may contribute to heterogeneity on the observed safety of investigational and approved therapies in studies involving RA patients from different origins.

Gabriel SE (2008) Cardiovascular morbidity and mortality in rheumatoid arthritis. Am J Med 10(Suppl 1):S9–S14CrossRef

Doran MF, Pond GR, Crowson CS, O’Fallon WM, Gabriel SE (2002) Trends in incidence and mortality in rheumatoid arthritis in Rochester, Minnesota, over a forty-year period. Arthritis Rheum 46:625–631CrossRefPubMed

Gabriel SE, Crowson CS, O'Fallon WM (1999) Mortality in rheumatoid arthritis: have we made an impact in 4 decades? J Rheumatol 26:2529–2533PubMed

Jacobsson LT, Hanson RL, Knowler WC et al (1994) Decreasing incidence and prevalence of rheumatoid arthritis in Pima Indians over a twenty-five-year period. Arthritis Rheum 37:1158–1165CrossRefPubMed

Kvalvik AG, Jones MA, Symmons DP (2000) Mortality in a cohort of Norwegian patients with rheumatoid arthritis followed from 1977 to 1992. Scand J Rheumatol 29:29–37CrossRefPubMed

Krause D, Schleusser B, Herborn G, Rau R (2000) Response to methotrexate treatment is associated with reduced mortality in patients with severe rheumatoid arthritis. Arthritis Rheum 43:14–21CrossRefPubMed

Riise T, Jacobsen BK, Gran JT, Haga HJ, Arnesen E (2001) Total mortality is increased in rheumatoid arthritis. A 17-year prospective study. Clin Rheumatol 20:123–127CrossRefPubMed

Young A, Koduri G, Batley M, Kulinskaya E, Gough A, Norton S, Dixey J, Early Rheumatoid Arthritis Study (ERAS) group (2007) Mortality in rheumatoid arthritis. Increased in the early course of disease, in ischaemic heart disease and in pulmonary fibrosis. Rheumatology (Oxford) 46:350–357CrossRef

Gabriel SE, Michaud K (2009) Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther 11:229CrossRefPubMedPubMedCentral

10.

Sacks JJ, Helmick CG, Langmaid G (2004) Deaths from arthritis and other rheumatic conditions, United States, 1979-1998. J Rheumatol 31:1823–1828PubMed

11.

Gonzalez A, Maradit Kremers H, Crowson CS, Nicola PJ, Davis JM, Therneau TM, Roger VL, Gabriel SE (2007) The widening mortality gap between rheumatoid arthritis patients and the general population. Arthritis Rheum 56:3583–3587CrossRefPubMed

12.

Ward MM (2001) Recent improvements in survival in patients with rheumatoid arthritis: better outcomes or different study designs? Arthritis Rheum 44:1467–1469CrossRefPubMed

13.

Wolfe F, Mitchell DM, Sibley JT, Fries JF, Bloch DA, Williams CA, Spitz PW, Haga M, Kleinheksel SM, Cathey MA (1994) The mortality of rheumatoid arthritis. Arthritis Rheum 37:481–494CrossRefPubMed

14.

Kremers HM, Crowson CS, Therneau TM, Roger VL, Gabriel SE (2008) High ten-year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients: a population-based cohort study. Arthritis Rheum 58:2268–2274CrossRefPubMed

15.

Peters MJ, van Halm VP, Voskuyl AE et al (2009) Does rheumatoid arthritis equal diabetes mellitus as an independent risk factor for cardiovascular disease? A prospective study. Arthritis Rheum 61:1571–1579CrossRefPubMed

16.

Maradit-Kremers H, Nicola PJ, Crowson CS, Ballman KV, Gabriel SE (2005) Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis Rheum 52:722–732CrossRefPubMed

17.

Crowson CS, Nicola PJ, Kremers HM, O'Fallon WM, Therneau TM, Jacobsen SJ (2005) How much of the increased incidence of heart failure in rheumatoid arthritis is attributable to traditional cardiovascular risk factors and ischemic heart disease? Arthritis Rheum 52:3039–3044CrossRefPubMed

18.

Kremer JM (2006) The CORRONA database. Autoimmun Rev 5:46–54CrossRefPubMed

19.

Wållberg-Jonsson S, Johansson H, Ohman ML, Rantapää-Dahlqvist S (1999) Extent of inflammation predicts cardiovascular disease and overall mortality in seropositive rheumatoid arthritis. A retrospective cohort study from disease onset. J Rheumatol 26:2562–2571PubMed

20.

Innala L, Möller B, Ljung L, Magnusson S, Smedby T, Södergren A, Öhman ML, Rantapää-Dahlqvist S, Wållberg-Jonsson S (2011) Cardiovascular events in early RA are a result of inflammatory burden and traditional risk factors: a five year prospective study. Arthritis Res Ther 13:R131CrossRefPubMedPubMedCentral

21.

European Cardiovascular disease statistics 2012. European Society of Cardiology, 2012. [Internet. Accessed April 2014.] available from: http://www.escardio.org/about/what/advocacy/EuroHeart/Pages/2012-CVD-statistics.aspx

22.

Miranda JJ, Herrera VM, Chirinos JA, Gómez LF, Perel P, Pichardo R, González A, Sánchez JR, Ferreccio C, Aguilera X, Silva E, Oróstegui M, Medina-Lezama J, Pérez CM, Suárez E, Ortiz AP, Rosero L, Schapochnik N, Ortiz Z, Ferrante D, Casas JP, Bautista LE (2013) Major cardiovascular risk factors in Latin America: a comparison with the United States. The Latin American Consortium of Studies in Obesity (LASO). PLoS One 8:e54056CrossRefPubMedPubMedCentral

23.

Goyal A, Yusuf S (2006) The burden of cardiovascular disease in the Indian subcontinent. Indian J Med Res 124:235–244PubMed

24.

Gupta R, Joshi P, Mohan V, Reddy KS, Yusuf S (2008) Epidemiology and causation of coronary heart disease and stroke in India. Heart 94:16–26CrossRefPubMed

25.

Heart Disease & Stroke Statistics −2014 Update. American Heart Association 2014. [Internet. Accessed September 2014.] Available from: http://www.heart.org/HEARTORG/General/Heart-and-Stroke-Association-Statistics_UCM_319064_SubHomePage.jsp

26.

Maradit-Kremers H, Crowson CS, Nicola PJ et al (2005) Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 52:402–411CrossRefPubMed

27.

Davis JM 3rd, Roger VL, Crowson CS, Kremers HM, Therneau TM, Gabriel SE (2008) The presentation and outcome of heart failure in patients with rheumatoid arthritis differs from that in the general population. Arthritis Rheum 58:2603–2611CrossRefPubMedPubMedCentral

28.

Wang TJ, Vasan RS (2005) Epidemiology of uncontrolled hypertension in the United States. Circulation 112:1651–1662CrossRefPubMed

Medicine Matters Rheumatology

Abstract