High Disease Activity over Time and Persistent Inflammation Are Associated with Increased Risk of Cardiovascular Disease in Patients with Early Rheumatoid Arthritis
Rydell, Emil LU
; Book, Christina
LU
; Nilsson, Jan-Åke
LU
; Willim, Minna
LU
; Jacobsson, Lennart
LU
and Turesson, Carl
LU
(2015)
American College of Rheumatology annual meeting 2015
In Arthritis & Rheumatology
67(Suppl. 10).
- Abstract
- Background/Purpose:
Rheumatoid arthritis (RA) is associated with an increased rate of cardiovascular (CV) disease. Systemic inflammation has been implicated as a key factor behind CV comorbidity in RA. The objective of this study was to investigate the impact of disease activity and inflammation over the first two years on the risk of subsequent CV events in patients with early RA.
Methods:
An inception cohort of patients with early RA (symptom duration
Results:
A total of 207 patients with early RA (70 % women, mean age 62 years) were followed from the 24-month visit to the first CV event, migration from the region, death or Dec 31, 2011. CV events occurred in 54 patients during the follow-up. A... (More) - Background/Purpose:
Rheumatoid arthritis (RA) is associated with an increased rate of cardiovascular (CV) disease. Systemic inflammation has been implicated as a key factor behind CV comorbidity in RA. The objective of this study was to investigate the impact of disease activity and inflammation over the first two years on the risk of subsequent CV events in patients with early RA.
Methods:
An inception cohort of patients with early RA (symptom duration
Results:
A total of 207 patients with early RA (70 % women, mean age 62 years) were followed from the 24-month visit to the first CV event, migration from the region, death or Dec 31, 2011. CV events occurred in 54 patients during the follow-up. A high disease activity over the first two years (defined as AUC for DAS28 above the median) was associated with a significantly increased risk of CV events (age-sex adjusted hazard ratio (HR) 2.03; 95 % confidence interval (CI) 1.15-3.60). In separate analyses, it was demonstrated that patients with CRP at two years within the highest quartile (>11 mg/l) had a significantly higher risk of CV events compared to those with lower CRP values (age-sex adjusted HR 1.82; 95 % CI 1.04-3.17). Results were similar in models adjusted for smoking, hypertension and diabetes in addition to age and sex (multivariate adjusted HRs for DAS28-AUC above the median: 2.05 (95% CI 1.13-3.73); for CRP>11 mg/l: 1.90 (95% CI 1.06-3.42)).
Conclusion:
A high disease activity during the first two years after RA diagnosis and a high CRP at the two-year follow-up were both associated with a doubled risk of CV events. These findings suggest that patients with persistently active RA are at particularly increased risk, and highlight the importance of disease control for CV prevention in patients with early RA. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/f020ef0a-3eb4-4286-931e-584f58d6aac0
- author
- Rydell, Emil
LU
; Book, Christina
LU
; Nilsson, Jan-Åke
LU
; Willim, Minna
LU
; Jacobsson, Lennart
LU
and Turesson, Carl
LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Arthritis & Rheumatology
- volume
- 67
- issue
- Suppl. 10
- article number
- 1565
- publisher
- John Wiley & Sons Inc.
- conference name
- American College of Rheumatology annual meeting 2015
- conference dates
- 2015-11-06
- ISSN
- 2326-5205
- language
- English
- LU publication?
- yes
- id
- f020ef0a-3eb4-4286-931e-584f58d6aac0
- alternative location
- https://acrabstracts.org/abstract/high-disease-activity-over-time-and-persistent-inflammation-are-associated-with-increased-risk-of-cardiovascular-disease-in-patients-with-early-rheumatoid-arthritis/
- date added to LUP
- 2022-11-10 09:19:03
- date last changed
- 2022-11-11 07:44:12
@misc{f020ef0a-3eb4-4286-931e-584f58d6aac0,
abstract = {{Background/Purpose:<br/><br/>Rheumatoid arthritis (RA) is associated with an increased rate of cardiovascular (CV) disease. Systemic inflammation has been implicated as a key factor behind CV comorbidity in RA. The objective of this study was to investigate the impact of disease activity and inflammation over the first two years on the risk of subsequent CV events in patients with early RA.<br/><br/>Methods:<br/><br/>An inception cohort of patients with early RA (symptom duration <br/>Results:<br/><br/>A total of 207 patients with early RA (70 % women, mean age 62 years) were followed from the 24-month visit to the first CV event, migration from the region, death or Dec 31, 2011. CV events occurred in 54 patients during the follow-up. A high disease activity over the first two years (defined as AUC for DAS28 above the median) was associated with a significantly increased risk of CV events (age-sex adjusted hazard ratio (HR) 2.03; 95 % confidence interval (CI) 1.15-3.60). In separate analyses, it was demonstrated that patients with CRP at two years within the highest quartile (>11 mg/l) had a significantly higher risk of CV events compared to those with lower CRP values (age-sex adjusted HR 1.82; 95 % CI 1.04-3.17). Results were similar in models adjusted for smoking, hypertension and diabetes in addition to age and sex (multivariate adjusted HRs for DAS28-AUC above the median: 2.05 (95% CI 1.13-3.73); for CRP>11 mg/l: 1.90 (95% CI 1.06-3.42)).<br/><br/>Conclusion:<br/><br/>A high disease activity during the first two years after RA diagnosis and a high CRP at the two-year follow-up were both associated with a doubled risk of CV events. These findings suggest that patients with persistently active RA are at particularly increased risk, and highlight the importance of disease control for CV prevention in patients with early RA.}},
author = {{Rydell, Emil and Book, Christina and Nilsson, Jan-Åke and Willim, Minna and Jacobsson, Lennart and Turesson, Carl}},
issn = {{2326-5205}},
language = {{eng}},
note = {{Conference Abstract}},
number = {{Suppl. 10}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Arthritis & Rheumatology}},
title = {{High Disease Activity over Time and Persistent Inflammation Are Associated with Increased Risk of Cardiovascular Disease in Patients with Early Rheumatoid Arthritis}},
url = {{https://acrabstracts.org/abstract/high-disease-activity-over-time-and-persistent-inflammation-are-associated-with-increased-risk-of-cardiovascular-disease-in-patients-with-early-rheumatoid-arthritis/}},
volume = {{67}},
year = {{2015}},
}