Assessment of Cardiovascular Disease Risk and Therapeutic Patterns among Urban Black Rheumatoid Arthritis Patients.
cardiovascular outcomes
erosive disease
extra-articular manifestations
rheumatoid arthritis
rheumatoid arthritis specific risk factors
seropositive rheumatoid arthritis
therapeutic patterns
traditional risk factors
Journal
Medical sciences (Basel, Switzerland)
ISSN: 2076-3271
Titre abrégé: Med Sci (Basel)
Pays: Switzerland
ID NLM: 101629322
Informations de publication
Date de publication:
20 Feb 2019
20 Feb 2019
Historique:
received:
26
12
2018
revised:
27
01
2019
accepted:
27
01
2019
entrez:
23
2
2019
pubmed:
23
2
2019
medline:
23
2
2019
Statut:
epublish
Résumé
Rheumatoid arthritis (RA) patients have nearly twice the risk of cardiovascular disease (CVD) compared to the general population. We aimed to assess, in a predominantly Black population, the prevalence of traditional and RA-specific CVD risk factors and therapeutic patterns. Utilizing ICD codes, we identified 503 RA patients ≥18 years old who were seen from 2010 to 2017. Of them, 88.5% were Black, 87.9% were women and 29.4% were smokers. CVD risk factors (obesity, diabetes, hypertension, dyslipidemia) were higher than in previously reported White RA cohorts. Eighty-seven percent of the patients had at least one traditional CVD risk factor, 37% had three or more traditional CVD risk factors and 58% had RA-specific risk factors (seropositive RA, >10 years of disease, joint erosions, elevated inflammatory markers, extra-articular disease, body mass index (BMI) < 20). CV outcomes (coronary artery disease/myocardial infarction, heart failure, atrial fibrillation and stroke) were comparable to published reports. Higher steroid use, which increases CVD risk, and lesser utilization of biologics (decrease CV risk) were also observed. Our Black RA cohort had higher rates of traditional CVD risk factors, in addition to chronic inflammation from aggressive RA, which places our patients at a higher risk for CVD outcomes, calling for revised risk stratification strategies and effective interventions to address comorbidities in this vulnerable population.
Identifiants
pubmed: 30791646
pii: medsci7020031
doi: 10.3390/medsci7020031
pmc: PMC6410013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Arthritis Res Ther. 2016 Aug 05;18(1):183
pubmed: 27495156
N Engl J Med. 2011 Dec 8;365(23):2205-19
pubmed: 22150039
Arthritis Rheum. 2005 Feb;52(2):402-11
pubmed: 15693010
J Lipid Res. 2001 Aug;42(8):1308-17
pubmed: 11483633
Circulation. 2001 Nov 13;104(20):2386-7
pubmed: 11705811
Can J Cardiol. 2018 Apr;34(4):381-389
pubmed: 29571422
Int J Rheum Dis. 2018 May;21(5):908-921
pubmed: 29671956
Arthritis Rheum. 2005 Aug;52(8):2293-9
pubmed: 16052597
Mediators Inflamm. 2017;2017:9632846
pubmed: 29430085
Arthritis Rheumatol. 2015 Jun;67(6):1449-55
pubmed: 25776112
Arthritis Rheumatol. 2015 May;67(8):1995-2003
pubmed: 25989470
Clin Exp Rheumatol. 2008 Sep-Oct;26(5 Suppl 51):S35-61
pubmed: 19026144
Circulation. 2003 Mar 11;107(9):1303-7
pubmed: 12628952
Arthritis Rheum. 2008 Dec 15;59(12):1690-7
pubmed: 19035419
Arthritis Rheum. 2006 Aug;54(8):2541-9
pubmed: 16868975
Ann Rheum Dis. 2010 Nov;69(11):1920-5
pubmed: 20444756
Ann Rheum Dis. 2008 Mar;67(3):375-9
pubmed: 17644537
Semin Arthritis Rheum. 1999 Jun;28(6):368-91
pubmed: 10406405
Front Pharmacol. 2018 Feb 06;9:55
pubmed: 29467655
Perm J. 2018 Jul 19;22:17-101
pubmed: 30010538
Postgrad Med J. 2014 Dec;90(1070):722-9
pubmed: 25431465
Arthritis Care Res (Hoboken). 2016 Jan;68(1):36-45
pubmed: 26097231
J Clin Invest. 1995 Dec;96(6):2758-67
pubmed: 8675645
Arthritis Rheum. 2007 Mar;56(3):820-30
pubmed: 17330254
Ann Rheum Dis. 2010 Sep;69(9):1580-8
pubmed: 20699241
Arthritis Rheum. 2005 Mar;52(3):722-32
pubmed: 15751097
Arthritis Rheum. 2003 Jul;48(7):1833-40
pubmed: 12847676
Ann Rheum Dis. 2011 Mar;70(3):482-7
pubmed: 21216812