Studies on symptomatic cardiovascular (CV) disease near the onset of rheumatoid arthritis (RA)
| Author, year (ref) | Population studied | RA diagnosis | Patients | Controls | Timing of endpoint observation | Evaluation method | Results |
|---|---|---|---|---|---|---|---|
| CV disease | |||||||
| Franklin, 201035 | NOAR cohort | IP: ≥2 swollen joints ≥4 weeks. Exclusion if not RA | 800 | Norfolk population | A median follow-up of 7.0 yr (IQR 5.8–8.1) | CV disease admissions identified from the records of a local acute care hospital | RR for CV disease admission was 1.9, CHD 1.9, stroke 1.1 (not significant) and all vascular disease admission 2.0 |
| Maradit-Kremers, 200836 | Residents of Rochester, Minnesota | ACR 1987 criteria | 553 | 574 | 0–10 years since RA incidence | Combined CV outcome including coronary revascularisation, MI, CHF and CV death | Increased absolute, excess and relative 10-year risk of CV disease. Incidence of outcome was increased soon after RA incidence date |
| Gonzalez, 200837 | Residents of Rochester, Minnesota | ACR 1987 criteria | 603 | 603 | RA incidence date | Angina pectoris, CHD, MI, heart failure, etc before incidence date | Similar prevalence of CV disease |
| Coronary heart disease | |||||||
| Lindhardsen, 201138 | Danish population | ICD codes M5-M6 and prescription of DMARDs | 10477 total, 295 in case–control study | Population | Treatment duration 0–3 years | MI | OR for MI was 1.7 during years 0–3 |
| Holmqvist, 201039 | Swedish ERAR cohort | ACR 1987 criteria | 7469 | 37024 | Diagnosis <18 months after symptom onset, median 6 months | MI | No difference at 1 year. At 1–4 years RR was 1.6 and at 5–12 years RR 1.6. No difference by RF status |
| Holmqvist, 200913 | Swedish EAR and EIRA cohort | ACR 1987 criteria | 8454 and 2025 | 42267 and 2760 | Before symptom onset | Nationwide register and self-reported CHD events | No increase in MI, angina pectoris or total CHD prior to RA. RF status did not modify this lack of excess risk |
| Maradit-Kremers, 200540 | Residents of Rochester, Minnesota | ACR 1987 criteria | 603 | 603 | 2-year period before RA diagnosis | Combined CHD event | OR for unrecognised MI 5.5, for hospitalised MI 3.40, and, surprisingly, for angina pectoris 0.59 |
| Congestive heart failure | |||||||
| Nicola, 200541 | Residents of Rochester, Minnesota | ACR 1987 criteria | 575 | 583 | 6–46 years from diagnosis (median follow-up 11.8 years) | Framingham Heart Study criteria | 1.7-fold incidence of CHF. The risk was higher among RF+ subjects |
ACR, American College of Rheumatology; CHD, coronary heart disease; CHF, congestive heart failure; CV, cardiovascular; EAR, Early Arthritis Register; EIRA, Epidemiological Investigation of Rheumatoid Arthritis; ERAR, Early Rheumatoid Arthritis Register; ICD, International Classification of Diseases; IP, inflammatory polyarthritis; MI, myocardial infarction; NOAR, the Norfolk Arthritis Register; RA, rheumatoid arthritis; RF, rheumatoid factor; RR, risk ratio.