Risk for Cardiovascular Disease Development in Rheumatoid Arthritis

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2024 Jun 4

PMID 38834973

Authors

Drazen Bedekovic

Ivica Bosnjak

Ines Bilic-Curcic

Damir Kirner

Sandra Saric

Srdan Novak

Affiliations

Soon will be listed here.

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.

Citing Articles

Correlation between myocardial work and disease activity in rheumatoid arthritis patients with preserved left ventricular ejection fraction: a retrospective study based on non-invasive pressure-strain loop：.

Yu X, Xi J, Wu J, Song R Clin Rheumatol. 2025; .

PMID: 40042530 DOI: 10.1007/s10067-025-07380-5.

Interleukin-27 and Autoimmune Disorders: A Compressive Review of Immunological Functions.

Yazdanpanah E, Pazoki A, Dadfar S, Nemati M, Sajad Siadati S, Tarahomi M Biomolecules. 2025; 14(12.

PMID: 39766196 PMC: 11672993. DOI: 10.3390/biom14121489.

Effects of 17β estradiol on blood pressure elevation in ovariectomized rats with collagen-induced arthritis via modulation of oxidative stress, inflammation, fibrosis, and apoptosis in the aorta involving TLR4/NOX4/NF-kβ and TGFβ1/fibronectin/α-SMA....

Govindasamy N, Barman M, Salleh N, Giribabu N, Shahzad H Naunyn Schmiedebergs Arch Pharmacol. 2024; .

PMID: 39702602 DOI: 10.1007/s00210-024-03700-9.

The Treatment with Xinfeng Capsule Can Reduce the Risk of Readmission for Patients with Rheumatoid arthritis:A Cohort Study of Approximately 10000 Individuals.

Wang F, Liu J, Fang Y, Sun Y, He M Int J Gen Med. 2024; 17:5285-5298.

PMID: 39563785 PMC: 11575443. DOI: 10.2147/IJGM.S491218.

References

Arts E, Popa C, den Broeder A, Donders R, Sandoo A, Toms T . Prediction of cardiovascular risk in rheumatoid arthritis: performance of original and adapted SCORE algorithms. Ann Rheum Dis. 2015; 75(4):674-80. DOI: 10.1136/annrheumdis-2014-206879. View

Nurmohamed M, Heslinga M, Kitas G . Cardiovascular comorbidity in rheumatic diseases. Nat Rev Rheumatol. 2015; 11(12):693-704. DOI: 10.1038/nrrheum.2015.112. View

Symmons D . Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol. 2002; 16(5):707-22. DOI: 10.1053/berh.2002.0257. View

Dadoun S, Zeboulon-Ktorza N, Combescure C, Elhai M, Rozenberg S, Gossec L . Mortality in rheumatoid arthritis over the last fifty years: systematic review and meta-analysis. Joint Bone Spine. 2012; 80(1):29-33. DOI: 10.1016/j.jbspin.2012.02.005. View

Boyer J, Gourraud P, Cantagrel A, Davignon J, Constantin A . Traditional cardiovascular risk factors in rheumatoid arthritis: a meta-analysis. Joint Bone Spine. 2010; 78(2):179-83. DOI: 10.1016/j.jbspin.2010.07.016. View

Farag M, Spinthakis N, Gue Y, Srinivasan M, Sullivan K, Wellsted D . Impaired endogenous fibrinolysis in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention is a predictor of recurrent cardiovascular events: the RISK PPCI study. Eur Heart J. 2018; 40(3):295-305. DOI: 10.1093/eurheartj/ehy656. View

Woolf A, Pfleger B . Burden of major musculoskeletal conditions. Bull World Health Organ. 2004; 81(9):646-56. PMC: 2572542. View

Meyer P, Anderson R, Ker J, Ally M . Rheumatoid arthritis and risk of cardiovascular disease. Cardiovasc J Afr. 2018; 29(5):317-321. PMC: 8962697. DOI: 10.5830/CVJA-2018-018. View

Hansen P, Feineis M, Abdulla J . Rheumatoid arthritis patients have higher prevalence and burden of asymptomatic coronary artery disease assessed by coronary computed tomography: A systematic literature review and meta-analysis. Eur J Intern Med. 2019; 62:72-79. DOI: 10.1016/j.ejim.2019.02.018. View

10.

Karpouzas G, Ormseth S, Hernandez E, Budoff M . Impact of Cumulative Inflammation, Cardiac Risk Factors, and Medication Exposure on Coronary Atherosclerosis Progression in Rheumatoid Arthritis. Arthritis Rheumatol. 2019; 72(3):400-408. DOI: 10.1002/art.41122. View

11.

Avina-Zubieta J, Thomas J, Sadatsafavi M, Lehman A, Lacaille D . Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis. 2012; 71(9):1524-9. DOI: 10.1136/annrheumdis-2011-200726. View

12.

Hollan I, Dessein P, Ronda N, Wasko M, Svenungsson E, Agewall S . Prevention of cardiovascular disease in rheumatoid arthritis. Autoimmun Rev. 2015; 14(10):952-69. DOI: 10.1016/j.autrev.2015.06.004. View

13.

Guerin M, Silvain J, Gall J, Darabi M, Berthet M, Frisdal E . Association of Serum Cholesterol Efflux Capacity With Mortality in Patients With ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol. 2018; 72(25):3259-3269. DOI: 10.1016/j.jacc.2018.09.080. View

14.

Gossec L, Salejan F, Nataf H, Nguyen M, Gaud-Listrat V, Hudry C . Challenges of cardiovascular risk assessment in the routine rheumatology outpatient setting: an observational study of 110 rheumatoid arthritis patients. Arthritis Care Res (Hoboken). 2013; 65(5):712-7. DOI: 10.1002/acr.21935. View

15.

Agca R, Heslinga S, Rollefstad S, Heslinga M, McInnes I, Peters M . EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2016; 76(1):17-28. DOI: 10.1136/annrheumdis-2016-209775. View

16.

Sakai R, Hirano F, Kihara M, Yokoyama W, Yamazaki H, Harada S . High prevalence of cardiovascular comorbidities in patients with rheumatoid arthritis from a population-based cross-sectional study of a Japanese health insurance database. Mod Rheumatol. 2015; 26(4):522-8. DOI: 10.3109/14397595.2015.1106682. View

17.

Jiang P, Li H, Li X . Diabetes mellitus risk factors in rheumatoid arthritis: a systematic review and meta-analysis. Clin Exp Rheumatol. 2014; 33(1):115-21. View

18.

Ozen G, Sunbul M, Atagunduz P, Direskeneli H, Tigen K, Inanc N . The 2013 ACC/AHA 10-year atherosclerotic cardiovascular disease risk index is better than SCORE and QRisk II in rheumatoid arthritis: is it enough?. Rheumatology (Oxford). 2015; 55(3):513-22. DOI: 10.1093/rheumatology/kev363. View

19.

Sokka T, Abelson B, Pincus T . Mortality in rheumatoid arthritis: 2008 update. Clin Exp Rheumatol. 2008; 26(5 Suppl 51):S35-61. View

20.

Habets K, Trouw L, Levarht E, Korporaal S, Habets P, de Groot P . Anti-citrullinated protein antibodies contribute to platelet activation in rheumatoid arthritis. Arthritis Res Ther. 2015; 17:209. PMC: 4548712. DOI: 10.1186/s13075-015-0665-7. View