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Excess risk of hospital admission for cardiovascular disease within the first 7 years from onset of inflammatory polyarthritis
  1. Jarrod Franklin1,
  2. Tracey M Farragher1,
  3. Mark Lunt1,
  4. Elizabeth M Camacho1,
  5. Diane Bunn1,2,
  6. Tarnya Marshall2,
  7. Deborah P M Symmons1
  1. 1arc Epidemiology Unit, The University of Manchester, Manchester, UK
  2. 2Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK
  1. Correspondence to Deborah P M Symmons, arc Epidemiology Unit, Manchester Academic Health Sciences Centre, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK; deborah.symmons{at}


Objectives Subjects with rheumatoid factor positive inflammatory polyarthritis (IP) are known to have increased mortality from cardiovascular disease (CVD). A study was undertaken to examine the risk and baseline predictors of admission with CVD in patients with recent-onset IP.

Methods Subjects are recruited by the Norfolk Arthritis Register if they present to primary or secondary care with ≥2 swollen joints lasting ≥4 weeks. This analysis includes subjects recruited between 1995 and 1999. Baseline data on lifestyle, demographic characteristics, disease and treatment characteristics were collected. CVD admissions were identified through record linkage with the only acute care hospital in the study region. First-episode hospitalisation rates were compared with those of the general population. Poisson regression was used to calculate the relative risk (RR) of admission for patients with IP (overall and for each risk factor). Death certificates were obtained from the national death register.

Results 800 patients with recent-onset IP were followed for a median of 7.0 years. 64 CVD-related hospitalisations were observed (11.7 per 1000 person-years). Patients with IP were twice as likely (RR=2.0; 95% CI 1.5 to 2.5) to be hospitalised for CVD as the general population. Difficulty walking at baseline was a significant predictor of CVD admission and baseline non-steroidal anti-inflammatory drug use was associated with a reduced risk of CVD admission.

Conclusions Patients with IP are at increased risk of CVD-related hospitalisation, within 7 years of symptom onset. Informing patients about lifestyle modification may reduce the risk of CVD.

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  • Funding This work was funded by the Arthritis Research Campaign, UK (grant reference 17552).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Norfolk and Norwich local research ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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