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Meta-Analysis
. 2016 Jun 16;11(6):e0157360.
doi: 10.1371/journal.pone.0157360. eCollection 2016.

Rheumatoid Arthritis Disadvantages Younger Patients for Cardiovascular Diseases: A Meta-Analysis

Jaap Fransen  1 , Seyyed M R Kazemi-Bajestani  2 , Sebastian J H Bredie  3 , Calin D Popa  1   4
Affiliations
Meta-Analysis

Rheumatoid Arthritis Disadvantages Younger Patients for Cardiovascular Diseases: A Meta-Analysis

Jaap Fransen et al. PLoS One. .

Abstract

Introduction: The incidence of cardiovascular diseases (CVD) is increased in rheumatoid arthritis (RA) patients. It remains unclear whether the load of RA increases cardiovascular (CV) risk especially in female and in younger RA patients. In the present study we aim to analyse the influence of age and gender on CV risk in RA relative to the general population, using meta-analysis of direct comparative studies.

Method: Systematic literature search was performed in MEDLINE for studies reporting on occurrence of CV events in RA as compared to the general population, stratified for gender and/or age. Quality was appraised using the Newcastle-Ottawa scale. Meta-analysis was performed on rate ratios using inverse variance methods.

Results: There were 1372 records screened and 13 studies included. RA females and males have a similar higher risk (95%CI) to develop stroke with RR 1.35 (1.30-1.40) and RR 1.31 (1.21-1.43); coronary artery disease with RR 1.65 (1.54-1.76) versus RR 1.55 ((1.41-1.69) in men; cardiovascular disease with RR 1.56 (1.49-1.62) versus 1.50 (1.41-1.60). The highest incidence of CV events was observed in the youngest patients, RR 2.59 (1.77-3.79), whereas older patients had the lowest relative risk when compared to the general population, RR 1.27 (1.16-1.38).

Conclusion: The relative risk of RA patients for CVD is age dependent, but does not depend on gender: the relative risk on CVD appears to be equally raised for males and females, while relatively young RA patients (<50 years) have the highest, and older patients the lowest relative risk.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of the published articles evaluated for inclusion in this meta-analysis.
Fig 2
Fig 2. The effect of gender on different CV events.
Similar risk of stroke (A), coronary artery disease (B) and CVD in general (C) among women and men with RA.
Fig 3
Fig 3. The effect of age on a”pooled” CVD outcome in patients with RA.
The groups are stratified based on the age in three subgroups: <50 years, 50–65 years and >65 years, respectively.
See this image and copyright information in PMC

References

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