Incidence and risk factors of major cardiovascular events in rheumatoid arthritis and psoriatic arthritis : A population-based cohort study

Copyright © 2024 Elsevier Inc. All rights reserved..

OBJECTIVE: To evaluate the incidence and risk factors of major adverse cardiovascular events (MACE) in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients.

METHODS: A population-based retrospective cohort of RA and PsA patients was identified in a citywide database. All patients recruited from Jan 2006 to Dec 2015 were followed until the end of 2018. The outcome was the occurrence of a first MACE. Covariates of interest included traditional cardiovascular (CV) risk factors, inflammatory markers and pharmacotherapies. The independent predictors of MACE were identified by the time-dependent cox proportional hazard models.

RESULTS: A total of 13,905 patients (12,233 RA and 1,672 PsA) were recruited. After a total of 119,571 patient-years of follow-up, 934 (6.7%) patients developed a first MACE. RA and PsA patients had similar adjusted incidence (incidence rate ratio 0.96, 95 % CI 0.75-1.22, p = 0.767). After adjusting for traditional CV risk factors, the time-varying erythrocyte sedimentation (ESR) rate and C-reactive protein (CRP) levels, and the use of glucocorticoids were independently associated with higher risk of MACE in both the RA and PsA cohorts. In RA, the use of methotrexate and non-steroidal anti-inflammatory drugs (NSAIDs) were associated with fewer MACE. The use of biologic disease modifying anti-rheumatic drugs was not associated with MACE in both RA and PsA.

CONCLUSION: The incidence of MACE was similar in RA and PsA. Systemic inflammation and glucocorticoid use independently increased the risk of MACE in inflammatory arthritis, while methotrexate and NSAIDs use were protective against the development of MACE in RA.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:65

Enthalten in:

Seminars in arthritis and rheumatism - 65(2024) vom: 30. März, Seite 152416

Sprache:

Englisch

Beteiligte Personen:

Meng, Huan [VerfasserIn]
Lam, Steven H [VerfasserIn]
So, Ho [VerfasserIn]
Tam, Lai-Shan [VerfasserIn]

Links:

Volltext

Themen:

Anti-Inflammatory Agents, Non-Steroidal
Antirheumatic Agents
Glucocorticoids
Journal Article
Major cardiovascular events (MACE)
Methotrexate
Psoriatic arthritis
Rheumatoid arthritis
Systemic inflammation
YL5FZ2Y5U1

Anmerkungen:

Date Completed 22.03.2024

Date Revised 22.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.semarthrit.2024.152416

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368587924