Background Data on increased cardiovascular disease (CV) risks in RA are abundant. Less is known about the use of therapeutic or prophylactic CV management in RA. Some studies report a lower use of secondary prevention drugs following acute ischemic events in RA.
Objectives To compare the use of selected classes of CV drugs distributions in RA and in the general population, overall and in subjects with a history of ischemic cardiac events.
Methods From the Outpatient register, we identified a population-based prevalent RA-cohort consisting of all individuals with two or more visits listing RA in non-primary outpatient care 2005-2008, with at least one visit in 2009 (n=34,133). For each subject, five general population comparators were sampled (n=170,665). From the Prescribed Drug Register, all filled prescriptions of low-dose acetylsalicylic acid (ASA), statins, beta-blockers, ACE- and AII-inhibitors, diuretics, and calcium channel blockers (antihypertensives) during 2009 were retrieved. Information on hospitalizations for myocardial infarction or unstable angina within the last five years (2005-2009) was retrieved from the Hospital Discharge Register.
Results Overall, the proportion of RA-patients and comparators treated with low-dose ASA (16%vs15%) and statins (19%vs20%) were similar but the proportion of patients treated with antihypertensives was higher (50%vs42%), similarly so across sex and age-groups (Table). 1,423 (4.2%) RA-patients and 4,063 (2.4%) comparators had a history of an acute ischemic cardiac event. Among these, the use of low-dose ASA (74%vs74%), at least one antihypertensive drug (96%vs96%) was similar, but use of statins was slightly less common in RA (75%vs80%). Among subjects without an acute ischemic cardiac event within 5 years, use of low-dose ASA (8%vs9%) and statins (11vs13% were largely similar but the proportion of RA treated with antihypertensives (42%vs35%) was higher.
Conclusions This preliminary analysis does not suggest any major difference in the use of secondary prophylaxis in RA with a history of ischemic cardiac events, but a slightly higher use of anti-hypertensive CV drugs in patients without a history of ischemic cardiac events. More detailed analyses will reveal whether this increased use reflects a met or unmet therapeutic need.
Disclosure of Interest None Declared