Risk for cardiovascular disease development in rheumatoid arthritis

Abstract

Background: Patients with rheumatoid arthritis have significant cardiovascular mortality and morbidity.

Objective: To investigate the effects of chronic inflammation in rheumatoid arthritis on cardiovascular morbidity association with cardiovascular risk factors risk factors. Mortality report is secondary just to show trends without sufficient statistical power as it is accidental endpoint.

Methods: A total of 201 individuals without previous cardiovascular disease, 124 with rheumatoid arthritis (investigation group) and 77 with osteoarthritis (control group), were included in the study and followed up for an average of 8 years to assess the development of fatal or non-fatal cardiovascular diseases. The incidence and prevalence of cardiovascular risk factors were also investigated.

Results: The total incidence of one or more fatal or nonfatal cardiovascular events was 43.9% in the investigation group and 37.5% in the control group. Of these patients, 31.7% and 30.9% survived cardiovascular events in the investigation and control groups, respectively. The most common cardiovascular disease among participants who completed the study and those who died during the study was chronic heart failure. The results of the subgroup analysis showed that strict inflammation control plays a central role in lowering cardiovascular risk.

Conclusion: A multidisciplinary approach to these patients is of paramount importance, especially with the cooperation of immunologists and cardiologists for early detection, prevention, and management of cardiovascular risks and diseases.

Keywords: Cardiovascular mortality; Cardiovascular risk; Chronic inflammation; Osteoarthritis; Rheumatoid arthritis.

Fig. 1

Influence of risk factors on disease progression. Legend: CVD- cardiovascular disease, DMT2-diabetes mellitus typ 2, BP- blood pressure, DMARD- disease modifying antirheumatic drug, GCOS- glucocoriticoides. NSAID-nonsteroidal antiinflammatory drugs