Mike J.L. Peters
,Vokko P. van Halm
,Alexandre E. Voskuyl
,Yvo M. Smulders
,Maarten Boers
,Willem F. Lems
,Marjolein visser
,Coen D.A. Stehouwer
,Jacqueline M. Dekker
,Giel Nijpels
,Rob Heine
,Ben A.C. Dijkmans
enMichael T. Nurmohamed
Objective
To compare the incidence of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) with the incidence in patients with type 2 diabetes mellitus (DM2) and that in the general population.
Design
Prospective, descriptive cohort study.
Method
In 2001-2002, 353 patients with RA were included in a cohort. All patients were seen after 3 years to determine the 3-year incidence of CVD. Cox proportional hazards models were used to compare this incidence with the 3-year incidence of CVD in a general population cohort consisting of 1852 people, of which 155 had DM2. Fatal and non-fatal CVD were classified according to the ICD-9 criteria.
Results
The 3-year incidence of CVD was 9.0% in patients with RA and 4.3% in the general population, corresponding to an incidence of 3.30 per 100 patient-years (95% CI: 2.08-4.25) and 1.51 per 100 person-years (95% CI: 1.18-1.84) respectively. Compared with the 1852 people in the general population cohort, the age and sex-adjusted hazard ratio for CVD in RA patients was 1.94 (95% CI: 1.24-3.05; p = 0.004). This risk did not change when patients with pre-existing CVD were excluded or when the analyses were adjusted for the presence of cardiovascular risk factors. Both RA patients without DM2 and patients with DM2 had a twofold increased risk of CVD risk compared with the general population without DM2, with hazard ratios of 2.16 (95% CI: 1.28-3.63) and 2.04 (95% CI: 1.12-3.67) respectively.
Conclusion
RA is associated with an increased risk of CVD and this risk is similar to that associated with DM2.
Reacties
Confounding bij RA als risicofactor hartvaatziekte