Cardiovascular mortality and cardiovascular event rates in patients with inflammatory rheumatic diseases in the CARdiovascular in rheuMAtology (CARMA) prospective study—results at 5 years of follow-up

Martín-Martínez, María Auxiliadora; Castañeda, Santos; Sánchez‐Alonso, Fernando; García-Gómez, Carmen; González‐Juanatey, Carlos; Sánchez-Costa, Jesús T.; Belmonte-López, María Angeles; Tornero-Molina, Jesús; Santos-Rey, José; González, Carmen Olga Sánchez; Quesada, E.; Moreno-Gil, María P; Cobo‐Ibáñez, Tatiana; Pinto-Tasnde, José A; Babío-Herráez, Jesús; Bonilla, Gema; Juan-Mas, Antonio; Manero-Ruiz, Francisco J; Baurés, Montserrat Romera; Bachiller‐Corral, Javier; Chamizo-Carmona, Eugenio; Uriarte-Ecenarro, M.; Barbadillo, C.; Fernández‐Carballido, Cristina; Aurrecoechea, Elena; Möller-Parrera, Ingrid; Llorca, Javier

doi:10.1093/rheumatology/keaa737

Cited by 20 publications

(17 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At that time, the CARMA project member speculated on the protective effect of the biologic therapy administered to a high number of patients, due to the favorable effect of biologics on the insulin resistance, lipid composition, and other beneficial metabolic effects mediated by these agents, as well as the effect on reducing inflammation. Likewise, the greater knowledge of the EULAR recommendation for the management of traditional CV risk factors among the members of the CARMA project may also have explained these favorable results ( 31 ). The discrepancy supports the gap in proper stratification and treatment of the patients with RA in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid Arthritis and Cardiovascular Risk: Retrospective Matched-Cohort Analysis Based on the RECORD Study of the Italian Society for Rheumatology

et al. 2021

View full text Add to dashboard Cite

Background: Rheumatoid arthritis (RA) is associated with an increase in cardiovascular (CV) risk. This issue maybe not only explained by a genetic component, as well as by the traditional CV risk factors, but also by an underestimation and undertreatment of concomitant CV comorbidities.Method: This was a retrospective matched-cohort analysis in the Italian RA real-world population based on the healthcare-administrative databases to assess the CV risk factors and incidence of CV events in comparison with the general population. Persistence and adherence to the CV therapy were also evaluated in both groups.Results: In a RA cohort (N = 21,201), there was a greater prevalence of hypertension and diabetes with respect to the non-RA subjects (N = 249,156) (36.9 vs. 33.4% and 10.2 vs. 9.6%, respectively), while dyslipidemia was more frequent in the non-RA group (15.4 vs. 16.5%). Compared with a non-RA cohort, the patients with RA had a higher incidence of atrial fibrillation (incidence rate ratio, IRR 1.28), heart failure (IRR 1.53), stroke (IRR 1.19), and myocardial infarction (IRR 1.48). The patients with RA presented a significantly lower persistence rate to glucose-lowering and lipid-lowering therapies than the controls (odds ratio, OR 0.73 [95% CI 0.6–0.8] and OR 0.82 [0.8–0.9], respectively). The difference in the adherence to glucose-lowering therapy was significant (OR 0.7 [0.6–0.8]), conversely no statistically significant differences emerged regarding the adherence to lipid-lowering therapy (OR 0.89 [95% CI 0.8–1.0]) and anti-hypertensive therapy (OR 0.96 [95% CI 0.9–1.0]).Conclusion: The patients with RA have a higher risk of developing CV events compared with the general population, partially explained by the excess and undertreatment of CV risk factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Rheumatoid Arthritis and Cardiovascular Risk: Retrospective Matched-Cohort Analysis Based on the RECORD Study of the Italian Society for Rheumatology

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A low level of education and general comorbidities (including CV diseases) were identified as predictors of death ( 16 ). In a Spanish study analyzing CV mortality and CV events at 5 years in different IRD, AS was found to have the highest risk of a first CV event [HR: 4.6 (1.32–15.99)], but without increased CV deaths ( 17 ). Finally, a recent meta-analysis concluded that CV mortality in AS was increased, with a relative risk (RR) of 1.46 [1.15–1.86] ( 18 ).…”

Section: Mortality In Axspamentioning

confidence: 99%

The Risk of Cardiovascular Diseases in Axial Spondyloarthritis. Current Insights

Toussirot

2021

Front. Med.

View full text Add to dashboard Cite

There is an increased cardiovascular (CV) risk in axial spondyloarthritis (axSpA), leading to increased CV mortality and morbidity in these patients. The factors that may explain this enhanced CV risk in axSpA are multiple, including traditional CV risk factors such as smoking, but also the inflammatory process and probably the use of non-steroidal anti-inflammatory drugs (NSAIDs). The CV involvement of axSpA may be detected at an early and pre-clinical stage, using non-invasive techniques. While NSAIDs play a deleterious role in the CV risk of axSpA, TNF inhibitors seem to have a beneficial impact, but this remains to be demonstrated in specific clinical studies. More data are needed to determine the potential effects of IL-17 inhibitors on the CV risk of axSpA. CV comorbidity has been mainly assessed in the radiographic form of axSpA, while limited data are available in patients with the non-radiographic form. The current management of axSpA must consider this CV comorbidity according to the EULAR recommendations. Rheumatologists play a determinant role in the detection of CV risk and current management of these patients is focused on the control of disease activity, suppression of inflammation, screening for and management of traditional CV risk factors, as well as the restriction of NSAID use.

show abstract

“…However, the CARdiovascular in rheuMAtology (CARMA) project in Spanish patients revealed a lower rate of cardiovascular events and cardiovascular deaths in patients with chronic inflammatory rheumatic diseases, including RA. 29 Different genetic components and biologics usage percentage in the two groups might be parts of the possible explanations. López-Mejías et al 30 summarized the genetic factors associated with the risk of cardiovascular disease in RA patients, including the HLA class II histocompatibility antigen, DRB1 beta chain ( HLA-DRB1 ) gene, especially the HLA-DRB1*04 shared epitope (SE) alleles, and some polymorphisms inside and outside the HLA region such as the TNFA rs1800629 polymorphism (located at TNFA promoter), the C -C chemokine receptor type 5 ( CCR5)Δ32 rs333 polymorphism (a 32-basepairs deletion), and the methylenetetrahydrofolate reductase (MTHFR) rs1801131 polymorphism.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with risk of major adverse cardiovascular events in patients with rheumatoid arthritis: a nationwide, population-based, case-control study

Chen

Liu

Lai

et al. 2021

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

Objectives: To investigate factors associated with major adverse cardiovascular events (MACEs) in patients with rheumatoid arthritis (RA). Methods: We conducted a nationwide, population-based, case-control study using Taiwan’s National Health Insurance Research Database for 2003–2013. From 2004 to 2012, we identified 108,319 newly diagnosed RA patients without previous MACEs, of whom 7,580 patients (7.0%) developed MACEs during follow-up. From these incident RA patients, we included 5,994 MACE cases and 1:4 matched 23,976 non-MACE controls for analysis. The associations of MACEs with comorbidities and use of anti-rheumatic medications within 1 year before the index date were examined using conditional logistic regression analyses. Results: Using multivariable conditional logistic regression analysis, the risk of MACE in RA patients was associated with use of golimumab [odd’s ratio (OR), 0.09; 95% confidence interval (CI), 0.01-0.67], abatacept (OR, 0.13; 95% CI, 0.02–0.93), hydroxychloroquine (OR, 0.90; 95% CI, 0.82-0.99), methotrexate (OR, 0.72; 95% CI, 0.64–0.81), cyclosporin (OR, 1.43; 95% CI, 1.07–1.91), nonsteroidal anti-inflammation drugs (NSAIDs) (OR, 1.36; 95% CI, 1.27–1.46), antiplatelet agent (OR, 2.47; 95% CI, 2.31-2.63), hypertension (without anti-hypertensive agents: OR, 1.04; 95% CI, 0.96-1.12; with anti-hypertensive agents: OR, 1.47; 95% CI, 1.36-1.59), diabetes (OR, 1.27; 95% CI, 1.18-1.37), hyperlipidemia without lipid-lowering agents (OR, 1.09; 95% CI, 1.01-1.17), ischemic heart disease (OR, 1.20; 95% CI, 1.10-1.31), and chronic obstructive pulmonary disease (COPD) (OR, 1.12; 95% CI, 1.03-1.23) in the parsimonious model. The risk of MACE in RA patients also increased markedly in participants younger than 65 years with some comorbidities. Conclusions: This population-based case-control study revealed that the use of golimumab, abatacept, hydroxychloroquine, and methotrexate were associated with a decreased risk of MACE development in newly diagnosed RA patients, while the use of cyclosporin, NSAIDs, and antiplatelet agents, and comorbidities, including hypertension, diabetes, hyperlipidemia without lipid-lowering agent therapy, ischemic heart disease, and COPD, were associated with an increased risk of MACE development in RA patients.

show abstract

Cardiovascular mortality and cardiovascular event rates in patients with inflammatory rheumatic diseases in the CARdiovascular in rheuMAtology (CARMA) prospective study—results at 5 years of follow-up

Cited by 20 publications

References 29 publications

Rheumatoid Arthritis and Cardiovascular Risk: Retrospective Matched-Cohort Analysis Based on the RECORD Study of the Italian Society for Rheumatology

Rheumatoid Arthritis and Cardiovascular Risk: Retrospective Matched-Cohort Analysis Based on the RECORD Study of the Italian Society for Rheumatology

The Risk of Cardiovascular Diseases in Axial Spondyloarthritis. Current Insights

Factors associated with risk of major adverse cardiovascular events in patients with rheumatoid arthritis: a nationwide, population-based, case-control study

Contact Info

Product

Resources

About