Cargando…
Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study
INTRODUCTION: We analyzed the prevalence of cardiovascular (CV) disease in patients with rheumatoid arthritis (RA) and its association with traditional CV risk factors, clinical features of RA, and the use of disease-modifying antirheumatic drugs (DMARDs) in a multinational cross-sectional cohort of...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2008
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453774/ https://www.ncbi.nlm.nih.gov/pubmed/18325087 http://dx.doi.org/10.1186/ar2383 |
_version_ | 1782157399702896640 |
---|---|
author | Naranjo, Antonio Sokka, Tuulikki Descalzo, Miguel A Calvo-Alén, Jaime Hørslev-Petersen, Kim Luukkainen, Reijo K Combe, Bernard Burmester, Gerd R Devlin, Joe Ferraccioli, Gianfranco Morelli, Alessia Hoekstra, Monique Majdan, Maria Sadkiewicz, Stefan Belmonte, Miguel Holmqvist, Ann-Carin Choy, Ernest Tunc, Recep Dimic, Aleksander Bergman, Martin Toloza, Sergio Pincus, Theodore |
author_facet | Naranjo, Antonio Sokka, Tuulikki Descalzo, Miguel A Calvo-Alén, Jaime Hørslev-Petersen, Kim Luukkainen, Reijo K Combe, Bernard Burmester, Gerd R Devlin, Joe Ferraccioli, Gianfranco Morelli, Alessia Hoekstra, Monique Majdan, Maria Sadkiewicz, Stefan Belmonte, Miguel Holmqvist, Ann-Carin Choy, Ernest Tunc, Recep Dimic, Aleksander Bergman, Martin Toloza, Sergio Pincus, Theodore |
author_sort | Naranjo, Antonio |
collection | PubMed |
description | INTRODUCTION: We analyzed the prevalence of cardiovascular (CV) disease in patients with rheumatoid arthritis (RA) and its association with traditional CV risk factors, clinical features of RA, and the use of disease-modifying antirheumatic drugs (DMARDs) in a multinational cross-sectional cohort of nonselected consecutive outpatients with RA (The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis Program, or QUEST-RA) who were receiving regular clinical care. METHODS: The study involved a clinical assessment by a rheumatologist and a self-report questionnaire by patients. The clinical assessment included a review of clinical features of RA and exposure to DMARDs over the course of RA. Comorbidities were recorded; CV morbidity included myocardial infarction, angina, coronary disease, coronary bypass surgery, and stroke. Traditional risk factors recorded were hypertension, hyperlipidemia, diabetes mellitus, smoking, physical inactivity, and body mass index. Unadjusted and adjusted hazard ratios (HRs) (95% confidence interval [CI]) for CV morbidity were calculated using Cox proportional hazard regression models. RESULTS: Between January 2005 and October 2006, the QUEST-RA project included 4,363 patients from 48 sites in 15 countries; 78% were female, more than 90% were Caucasian, and the mean age was 57 years. The prevalence for lifetime CV events in the entire sample was 3.2% for myocardial infarction, 1.9% for stroke, and 9.3% for any CV event. The prevalence for CV risk factors was 32% for hypertension, 14% for hyperlipidemia, 8% for diabetes, 43% for ever-smoking, 73% for physical inactivity, and 18% for obesity. Traditional risk factors except obesity and physical inactivity were significantly associated with CV morbidity. There was an association between any CV event and age and male gender and between extra-articular disease and myocardial infarction. Prolonged exposure to methotrexate (HR 0.85; 95% CI 0.81 to 0.89), leflunomide (HR 0.59; 95% CI 0.43 to 0.79), sulfasalazine (HR 0.92; 95% CI 0.87 to 0.98), glucocorticoids (HR 0.95; 95% CI 0.92 to 0.98), and biologic agents (HR 0.42; 95% CI 0.21 to 0.81; P < 0.05) was associated with a reduction of the risk of CV morbidity; analyses were adjusted for traditional risk factors and countries. CONCLUSION: In conclusion, prolonged use of treatments such as methotrexate, sulfasalazine, leflunomide, glucocorticoids, and tumor necrosis factor-alpha blockers appears to be associated with a reduced risk of CV disease. In addition to traditional risk factors, extra-articular disease was associated with the occurrence of myocardial infarction in patients with RA. |
format | Text |
id | pubmed-2453774 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-24537742008-07-12 Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study Naranjo, Antonio Sokka, Tuulikki Descalzo, Miguel A Calvo-Alén, Jaime Hørslev-Petersen, Kim Luukkainen, Reijo K Combe, Bernard Burmester, Gerd R Devlin, Joe Ferraccioli, Gianfranco Morelli, Alessia Hoekstra, Monique Majdan, Maria Sadkiewicz, Stefan Belmonte, Miguel Holmqvist, Ann-Carin Choy, Ernest Tunc, Recep Dimic, Aleksander Bergman, Martin Toloza, Sergio Pincus, Theodore Arthritis Res Ther Research Article INTRODUCTION: We analyzed the prevalence of cardiovascular (CV) disease in patients with rheumatoid arthritis (RA) and its association with traditional CV risk factors, clinical features of RA, and the use of disease-modifying antirheumatic drugs (DMARDs) in a multinational cross-sectional cohort of nonselected consecutive outpatients with RA (The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis Program, or QUEST-RA) who were receiving regular clinical care. METHODS: The study involved a clinical assessment by a rheumatologist and a self-report questionnaire by patients. The clinical assessment included a review of clinical features of RA and exposure to DMARDs over the course of RA. Comorbidities were recorded; CV morbidity included myocardial infarction, angina, coronary disease, coronary bypass surgery, and stroke. Traditional risk factors recorded were hypertension, hyperlipidemia, diabetes mellitus, smoking, physical inactivity, and body mass index. Unadjusted and adjusted hazard ratios (HRs) (95% confidence interval [CI]) for CV morbidity were calculated using Cox proportional hazard regression models. RESULTS: Between January 2005 and October 2006, the QUEST-RA project included 4,363 patients from 48 sites in 15 countries; 78% were female, more than 90% were Caucasian, and the mean age was 57 years. The prevalence for lifetime CV events in the entire sample was 3.2% for myocardial infarction, 1.9% for stroke, and 9.3% for any CV event. The prevalence for CV risk factors was 32% for hypertension, 14% for hyperlipidemia, 8% for diabetes, 43% for ever-smoking, 73% for physical inactivity, and 18% for obesity. Traditional risk factors except obesity and physical inactivity were significantly associated with CV morbidity. There was an association between any CV event and age and male gender and between extra-articular disease and myocardial infarction. Prolonged exposure to methotrexate (HR 0.85; 95% CI 0.81 to 0.89), leflunomide (HR 0.59; 95% CI 0.43 to 0.79), sulfasalazine (HR 0.92; 95% CI 0.87 to 0.98), glucocorticoids (HR 0.95; 95% CI 0.92 to 0.98), and biologic agents (HR 0.42; 95% CI 0.21 to 0.81; P < 0.05) was associated with a reduction of the risk of CV morbidity; analyses were adjusted for traditional risk factors and countries. CONCLUSION: In conclusion, prolonged use of treatments such as methotrexate, sulfasalazine, leflunomide, glucocorticoids, and tumor necrosis factor-alpha blockers appears to be associated with a reduced risk of CV disease. In addition to traditional risk factors, extra-articular disease was associated with the occurrence of myocardial infarction in patients with RA. BioMed Central 2008 2008-03-06 /pmc/articles/PMC2453774/ /pubmed/18325087 http://dx.doi.org/10.1186/ar2383 Text en Copyright © 2008 Naranjo et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Naranjo, Antonio Sokka, Tuulikki Descalzo, Miguel A Calvo-Alén, Jaime Hørslev-Petersen, Kim Luukkainen, Reijo K Combe, Bernard Burmester, Gerd R Devlin, Joe Ferraccioli, Gianfranco Morelli, Alessia Hoekstra, Monique Majdan, Maria Sadkiewicz, Stefan Belmonte, Miguel Holmqvist, Ann-Carin Choy, Ernest Tunc, Recep Dimic, Aleksander Bergman, Martin Toloza, Sergio Pincus, Theodore Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study |
title | Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study |
title_full | Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study |
title_fullStr | Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study |
title_full_unstemmed | Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study |
title_short | Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study |
title_sort | cardiovascular disease in patients with rheumatoid arthritis: results from the quest-ra study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453774/ https://www.ncbi.nlm.nih.gov/pubmed/18325087 http://dx.doi.org/10.1186/ar2383 |
work_keys_str_mv | AT naranjoantonio cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT sokkatuulikki cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT descalzomiguela cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT calvoalenjaime cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT hørslevpetersenkim cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT luukkainenreijok cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT combebernard cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT burmestergerdr cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT devlinjoe cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT ferraccioligianfranco cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT morellialessia cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT hoekstramonique cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT majdanmaria cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT sadkiewiczstefan cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT belmontemiguel cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT holmqvistanncarin cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT choyernest cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT tuncrecep cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT dimicaleksander cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT bergmanmartin cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT tolozasergio cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT pincustheodore cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy AT cardiovasculardiseaseinpatientswithrheumatoidarthritisresultsfromthequestrastudy |