Coronary heart disease is associated with a worse clinical outcome of hand osteoarthritis: a cross-sectional and longitudinal study

Abstract

ObjectiveTo determine whether cardiometabolic factors are associated with hand osteoarthritis (HOA) symptoms, radiographic severity and progression in a post hoc analysis of the phase III Strontium ranelate Efficacy in Knee OsteoarthrItis triAl (SEKOIA) trial, designed to determine the effect of strontium ranelate on knee osteoarthritis (OA).MethodsAmong the 1683 patients randomised in the SEKOIA study, 869 with radiographic HOA at baseline (rHOA≥2 joints with Kellgren-Lawrence grade ≥2) were included in a cross-sectional analysis. For longitudinal study, we included only the 307 patients with rHOA at baseline from the placebo group. We evaluated whether baseline symptomatic HOA, radiographic severity and clinical and rHOA progression were associated with coronary heart disease and/or metabolic diseases (obesity, diabetes and hypertension, dyslipidaemia) by multivariate regression analysis.ResultsAt baseline, 869 patients (72% women) were included in the cross-sectional analysis; 26% were symptomatic. On multivariate analysis, symptomatic HOA was associated with coronary heart disease (OR 3.59, 95% CI (1.78 to 7.26)) but not metabolic diseases. After a mean follow-up of 2.6 years, for the 307 participants in the placebo group, on multivariate analysis, worse clinical HOA outcome was associated with coronary heart disease (OR 2.91, 95% CI (1.02 to 8.26)). The slow radiographic progression did not allow for revealing any associated factors.ConclusionsSymptomatic HOA and worse HOA clinical course are associated with coronary heart disease. These results strengthen the systemic component of HOA and the association between OA pain and cardiac events.Trial registration numberISRCTN41323372.

The presence of erosive joints is a strong predictor of radiological progression in hand osteoarthritis: results of a 2-year prospective follow-up of the Liège Hand Osteoarthritis Cohort (LIHOC)

“…The detection of at least one new erosive or remodeled joint (phase E or R), on the VV scale, in accordance with the suggestion of Courties et al [ 30 ];…”

“…We used three separate and independent approaches to define a radiographic progression: The detection of at least one new erosive or remodeled joint (phase E or R), on the VV scale, in accordance with the suggestion of Courties et al [ 30 ]; The observation in at least one joint, of a progression of at least one anatomical stage, using the VV score, and excluding the progression from an N to S stage, as previously described by Meersseman et al [ 31 ]; A change in the KL total score above the score considered as the smallest detectable difference ([SDD] = 3.215) for this scale [ 32 ]. …”

Is aquatic exercise more effective than land-based exercise for knee osteoarthritis?

“…Increasing evidence suggests that knee OA is not only a type of joint disorder, but it is also a risk factor for other diseases. [34–36] Patients with painful knee OA have a higher risk of cardiovascular disease-specific and all-cause mortality compared to non-OA individuals. [37] Furthermore, substantial medical resources and costs are involved in the treatment of knee OA, so there is an urgent need to explore methods of slowing down or even attenuating the progression of this disease.…”

Epidemiology of osteoarthritis: literature update

“…A meta-analysis found that the risk of myocardial infarction was significantly increased in OA and other types of arthritis [20]. Other studies similarly linked coronary heart disease with OA [21,22]. In parallel, the Chingford Cohort study found an increased risk of cardiovascular disease-specific and all-cause mortality among women with symptomatic KOA compared to women without signs/symptoms of OA [23].…”