Table 2

Studies on symptomatic cardiovascular (CV) disease near the onset of rheumatoid arthritis (RA)

Author, year (ref)Population studiedRA diagnosisPatientsControlsTiming of endpoint observationEvaluation methodResults
CV disease
Franklin, 201035NOAR cohortIP: ≥2 swollen joints ≥4 weeks. Exclusion if not RA800Norfolk populationA median follow-up of 7.0 yr (IQR 5.8–8.1)CV disease admissions identified from the records of a local acute care hospitalRR for CV disease admission was 1.9, CHD 1.9, stroke 1.1 (not significant) and all vascular disease admission 2.0
 Maradit-Kremers, 200836Residents of Rochester, MinnesotaACR 1987 criteria5535740–10 years since RA incidenceCombined CV outcome including coronary revascularisation, MI, CHF and CV deathIncreased absolute, excess and relative 10-year risk of CV disease. Incidence of outcome was increased soon after RA incidence date
Gonzalez, 200837Residents of Rochester, MinnesotaACR 1987 criteria603603RA incidence dateAngina pectoris, CHD, MI, heart failure, etc before incidence dateSimilar prevalence of CV disease
Coronary heart disease
Lindhardsen, 201138Danish population ICD codes M5-M6 and prescription of DMARDs10477 total, 295 in case–control studyPopulationTreatment duration 0–3 yearsMIOR for MI was 1.7 during years 0–3
Holmqvist, 201039Swedish ERAR cohortACR 1987 criteria746937024Diagnosis <18 months after symptom onset, median 6 monthsMINo 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, 200913Swedish EAR and EIRA cohortACR 1987 criteria8454 and 202542267 and 2760Before symptom onsetNationwide register and self-reported CHD eventsNo increase in MI, angina pectoris or total CHD prior to RA. RF status did not modify this lack of excess risk
 Maradit-Kremers, 200540Residents of Rochester, MinnesotaACR 1987 criteria6036032-year period before RA diagnosisCombined CHD eventOR for unrecognised MI 5.5, for hospitalised MI 3.40, and, surprisingly, for angina pectoris 0.59
Congestive heart failure
Nicola, 200541Residents of Rochester, MinnesotaACR 1987 criteria5755836–46 years from diagnosis (median follow-up 11.8 years)Framingham Heart Study criteria1.7-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.