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. 2019 Sep-Oct;37(5):731-739.
Epub 2019 Jan 3.

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

María A Martín-Martínez  1 , Santos Castañeda  2 , Carlos González-Juanatey  3 , Fernando Sánchez-Alonso  1 , Carmen García-Gómez  4 , Ruth López-González  5 , Jesús Babío-Herraiz  6 , Antonio Juan-Mas  7 , María P Moreno-Gil  8 , Carmen O Sánchez-González  9 , Montserrat Romera-Baurés  10 , José A Pinto-Tasende  11 , Jesús Tornero-Molina  12 , Dolores Fábregas-Canales  13 , Javier Llorca  14 , Miguel A González-Gay  15 ; CARMA Project Collaborative Group
Affiliations
  • PMID: 30620291
Free article

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

María A Martín-Martínez et al. Clin Exp Rheumatol. 2019 Sep-Oct.
Free article

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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