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Incidence of first cardiovascular event in Spanish patients with inflammatory rheumatic diseases: prospective data from the CARMA project

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16

 

  1. Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
  2. Division of Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain.
  3. Division of Cardiology, Hospital Lucus Augusti, Lugo, Spain.
  4. Research Unit of Spanish Society of Rheumatology, Madrid, Spain.
  5. Division of Rheumatology, Consorci Sanitari de Terrassa, Barcelona, Spain.
  6. Division of Rheumatology, Hospital General Virgen de la Concha, Zamora, Spain.
  7. Division of Rheumatology, Hospital de Cabueñes, Gijón, Spain.
  8. Division of Rheumatology, Hospital Son Llatzer, Palma de Mallorca, Spain.
  9. Division of Rheumatology, Hospital San Pedro de Alcántara, Cáceres, Spain.
  10. Division of Rheumatology, Hospital del Sureste, Madrid, Spain.
  11. Division of Rheumatology, Hospital de Bellvitge, Barcelona, Spain.
  12. Division of Rheumatology, Complejo Hospitalario A Coruña, Xubias de Arriba, A Coruña, Spain.
  13. Division of Rheumatology, Hospital Universitario de Guadalajara, Spain.
  14. Division of Rheumatology, Hospital de Barbastro, Huesca, Spain.
  15. Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria and CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain.
  16. Div. Rheumatology, Univ. Cantabria, Hosp. Univ. Marqués de Valdecilla, Santander; Epidemiology, Genetics and Atherosclerosis Res. Group on Systemic Inflammatory Diseases, Rheumatology Div., IDIVAL, Santander, Spain; Univ.of the Witwatersrand, South Africa

on behalf of the CARMA Project Collaborative Group

CER11574
2019 Vol.37, N°5
PI 0731, PF 0739
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PMID: 30620291 [PubMed]

Received: 01/08/2018
Accepted : 05/11/2018
In Press: 03/01/2019
Published: 29/08/2019

Abstract

OBJECTIVES:
To determine the incidence and risk factors of first cardiovascular event (CVE) in patients with chronic inflammatory rheumatic diseases (CIRD).
METHODS:
Analysis of data after 2.5 years of follow-up from the prospective study CARMA project, that includes patients with CIRD [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA)] and matched individuals without CIRD from 67 hospitals in Spain. CVE cumulative incidence per 1000 patients was calculated after 2.5 years from the start of the project. Weibull proportional hazard model was used to calculate hazard ratio (HR) and 95% confidence interval (95% CI) of the risk factors.
RESULTS:
2595 (89.1%) patients completed the 2.5 years of follow-up visit. Cumulative incidence of CVE in patients with CIRD was 15.30 cases per 1000 patients (95% CI: 12.93-17.67), being higher in the subgroup with AS; 22.03 (95% CI: 11.01–33.04). Patients with AS (HR: 4.11; 95% CI: 1.07-15.79), those with older age (HR: 1.09; 95% CI: 1.05-1.13), systolic hypertension (HR: 1.02; 95% CI: 1.00-1.04) and long duration of the disease (HR: 1.07; 95% CI: 1.03-1.12) were at higher risk of first CVE during the 2.5 years of follow-up. In contrast, female gender was a protective factor (HR: 0.43; 95% CI: 0.18-1.00).
CONCLUSIONS:
Among CIRD patients prospectively followed-up at rheumatology outpatient clinics, those with AS show higher risk of first CVE. Besides cardiovascular risk factors, such as hypertension, being a man and older as well as having a long disease duration increase the risk of CVE in patients with CIRD.

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