Table 3

Association of methotrexate use with cardiovascular disease events in veterans with rheumatoid arthritis*

Event category†HR (95% CI)P value
Composite 0.76 (0.58 to 0.99) 0.04
HF hospitalisation 0.43 (0.24 to 0.77) 0.005
MACE0.82 (0.63 to 1.06)0.12
CAD0.84 (0.55 to 1.28)0.42
Stroke0.72 (0.34 to 1.53)0.39
CVD Death0.79 (0.55 to 1.13)0.19
  • Values listed in bold indicate p<0.05.

  • *Marginal structural models adjusting for time-varying age, BMI, RA disease activity, and medication use (prednisone, conventional and biological DMARDs, ASA and NSAIDs). Time-invariant variables assessed at baseline included sex, race, smoking status, RA duration, comorbidities and statin use. Primary analysis includes variables from the current and prior visit into the propensity to receive MTX.

  • †MACE is a composite of CAD, stroke and CVD death. CAD includes acute myocardial infarction, percutaneous coronary intervention or coronary artery bypass.

  • .ASA, aspirin; BMI, body mass index; CAD, coronary artery disease; CVD, cardiovascular disease; DMARD, disease-modifying anti-rheumatic drug; HF, heart failure; MACE, major adverse cardiovascular event; MTX, methotrexate; NSAIDs, non-steroidal anti-inflammatory drugs; RA, rheumatoid arthritis.