Both markers of rheumatoid arthritis severity and traditional markers of cardiovascular risk are important and independent predictors of future CV events in RA patients.
Dr. Daniel H. Solomon, chief of the section of clinical sciences in the division of rheumatology, immunology, and allergy at the Brigham and Women's Hospital, Boston, and his associates examined the relative importance of the two types of markers in predicting CV events using a large, longitudinal cohort of RA patients, CORRONA (Consortium of Rheumatology Researchers of North America). Enrollment began in 2002, and patients were followed through 2006. For this analysis, 10,156 subjects were followed for a median of 22 months for the development of incident MI, stroke, or transient ischemic attack.
The study subjects' mean age was 59 years, and 75% were women. Median disease duration at baseline was 7 years. There were 29 MIs and 47 strokes or TIAs during follow-up, for an event rate of about 4 per 1,000 person-years.
Six traditional markers of CV risk – hypertension, diabetes, hyperlipidemia, current tobacco use, known cardiovascular disease, and a family history of premature CV events – were important predictors of CV events during follow-up. In addition, seven markers of RA severity were strong, independent predictors of CV risk.
Moreover, the incidence of CV events escalated as the number of either type of risk factor increased. The incidence was 0 in patients with no CV risk factors and no markers of RA severity, and it rose to 7.5 per 1,000 person-years in patients with two or more CV risk factors and three or more markers of RA severity, the researchers wrote (Ann. Rheum. Dis. 2010;69:1920-5).
There was no specific support for this analysis. Dr. Solomon receives support from the National Institutes of Health, the Agency for Healthcare Quality and Research, the Arthritis Foundation, Abbott, and Amgen.