NEW YORK (Reuters Health) Jul 30 - Rheumatoid arthritis disease activity is not a risk factor for myocardial infarction, according to a report by researchers in Holland, published in the August issue of the Annals of the Rheumatic Diseases.
"Patients with rheumatoid arthritis undoubtedly have a higher risk of cardiovascular events than people of the general population; however, we have shown that this risk does not depend on the height of the disease activity," Dr. B. J. Radovits from Radboud University Nijmegen Medical Center, told Reuters Health. "Probably, lower disease activity is already sufficient to cause an elevation of cardiovascular risk in rheumatoid arthritis patients." Dr. Radovits and colleagues investigated whether the level of disease activity is associated with the risk of myocardial infarction in a case-control study of patients with rheumatoid arthritis. Included in the study was a subgroup with rheumatoid arthritis and myocardial infarction (cases) or rheumatoid arthritis only (controls.) Compared with controls, rheumatoid arthritis patients with myocardial infarction were more often older and male. They also had a higher body mass index, total cholesterol, LDL cholesterol, triglycerides, and atherogenic index and lower HDL cholesterol levels, the authors report. In contrast, time-averaged disease activity scores and disease duration were not related to the risk of myocardial infarction. "In view of the currently available evidence, it is likely that traditional cardiovascular risk factors, as well as the chronic inflammatory processes, mediate the cardiovascular risk in patients with rheumatoid arthritis," the investigators write. "The relative degree of inflammation seems not to contribute to the risk." "Rheumatologists should monitor carefully and treat effectively the traditional cardiovascular risk factors in patients with rheumatoid arthritis," Dr. Radovits concluded. Ann Rheum Dis 2009;68:1271-1276.Predicting Cardiovascular Disease Risk For Rheumatoid Arthritis Patients
Main Category: Arthritis / Rheumatology
Also Included In: Cardiovascular / Cardiology; Pain / Anesthetics; Seniors / Aging
Article Date: 08 Nov 2007 - 1:00 PDT
People with rheumatoid arthritis have a higher risk for developing heart disease than the general population; however, it is difficult to identify which patients are at increased risk. Researchers at Mayo Clinic have developed a simple approach to predict heart disease in these patients within ten years of their initial diagnosis of rheumatoid arthritis. The findings of this Mayo Clinic research study are being presented at the American College of Rheumatology Annual Scientific Meeting in Boston, Nov. 6-11, 2007.
Previous research by the Mayo Clinic team identified a link between rheumatoid arthritis patients and increased risk for heart disease. A major challenge for physicians is detection and prevention of heart disease in rheumatoid arthritis patients who show no symptoms of heart disease. The goal of this latest study is to find a way to detect the risk of heart disease earlier in patients with rheumatoid arthritis.
"Rheumatoid arthritis sufferers are dealing with significant pain and stress, therefore cardiovascular disease prevention may be delayed," says Hilal Maradit Kremers, M.D., lead study investigator and research associate in the Mayo Clinic Department of Health Sciences Research, "Our findings indicate that evaluation of cardiovascular risk based on risk factor profiles of individual patients can help physicians identify high risk rheumatoid arthritis patients and assist with decisions concerning cardiovascular disease prevention."
Mayo Clinic researchers estimated the 10-year absolute risk of cardiovascular disease in a group of 553 patients diagnosed with rheumatoid arthritis and compared them with 574 patients of the same age and gender who did not have rheumatoid arthritis. The researchers collected detailed information about all study subjects' cardiac events and their traditional cardiovascular risk factors: diabetes, blood pressure, cholesterol, body mass index and smoking.
Using absolute risk analysis methods, researchers discovered that 85 percent of those 60 to 69 year olds who were newly diagnosed with rheumatoid arthritis had a 1 in 5 chance of developing a serious cardiovascular event, compared to only 40 percent of patients who did not have rheumatoid arthritis. In each age group, cardiovascular risk in rheumatoid arthritis patients was similar to that of nonrheumatoid arthritis subjects who were 5-10 years older.
"These results emphasize the importance of performing a comprehensive cardiovascular risk assessment for all newly diagnosed rheumatoid arthritis patients," says Sherine Gabriel, M.D., the study's senior author and Mayo Clinic rheumatologist and epidemiologist.
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Article adapted by Medical News Today from original press release.
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Rheumatoid arthritis is a chronic, autoimmune disease that causes pain, swelling, stiffness and loss of function in multiple joints. Rheumatoid arthritis is a systemic disease and also may affect other organs of the body including the lungs, heart and kidneys. Rheumatoid arthritis affects about 2.1 million Americans, mostly women and generally striking between the ages of 20 and 50.
Members of the Mayo Clinic study team include: Hilal Maradit-Kremers, M.D., Cynthia Crowson, Terry Therneau, Ph.D; Veronique Roger, M.D., and Sherine Gabriel, M.D. Their work was supported by grants from the National Institutes of Health; in particular, the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Source: Amy J. Tieder
Mayo Clinic
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