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THU0163 The association between inflammatory joint disorders and coronary heart disease: nationwide register study in 50 444 patients
  1. P Muilu1,
  2. V Rantalaiho2,3,
  3. H Kautiainen4,5,
  4. L Virta6,
  5. K Puolakka7
  1. 1Department of Medicine, Tampere University Hospital
  2. 2Centre for Rheumatic Diseases, Tampere University Hospital
  3. 3Faculty of Medicine and life sciences, University of Tampere, Tampere
  4. 4Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki
  5. 5Unit of Primary Health Care, Turku University Hospital
  6. 6Social Insurance Institution of Finland, Turku
  7. 7Department of Medicine, South-Karelia Central Hospital, Lappeenranta, Finland

Abstract

Background Inflammatory joint disorders (IJD) are associated with cardiovascular (CV) problems, including coronary heart disease (CHD). This association is best known for rheumatoid arthritis (RA); but also for ankylosing spondylitis and psoriatic arthritis (PsA). However, these findings are mainly based on materials from an era of less active treatment of the IJD's and thus progress in this theory may have happened. Further, many cases fail to fulfil any classification criteria. We found no published data on CV risk in unspecified arthritis (UA).

Objectives To investigate the association between the five most common IJDs and CHD based on a nationwide large register data in Finland during 2000–14.

Methods From the register maintained by the Social Insurance Institution (SII), we collected data on all Finnish patients granted a new special reimbursement (SR) on medications for the following IJDs during 2000–14: seropositive RA (ICD10 code M05), seronegative RA (M06), UA (M13), spondyloarthritis (SpA) (M45–46), and PsA (L40). For these patients, Population Register Centre matched three controls, standardized for age, sex, and place of residence. The index date was determined to be the date when the SR for IJD came effective. From the case and control groups we analysed the frequency of individuals that had SR also for CHD (ICD10 codes I20–25) at the index date, or to whom it was granted by SII during the observation period.

Results Altogether 201 776 individuals (50 444 cases and 151 332 controls) were identified. The frequencies of the individuals having CHD by the index date and the incidences of CHD during follow-up are presented in table 1.

Conclusions Compared to general population, CHD was overrepresented at RA diagnosis, especially in seropositive men and seronegative women, while other patients had comparable rates of CHD with the population. After the index day, the incidence of CHD was increased in all patient groups except for men with seronegative RA and women with seropositive RA or SpA. Thus, the CV risk associated to IJDs remains in this millennium, and also pertains to UA.

Disclosure of Interest None declared

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