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Published in: Rheumatology International 2/2024

29-12-2023 | Rheumatoid Arthritis | Observational Research

Prevalence of cardiovascular diseases and traditional cardiovascular risk factors in patients with rheumatoid arthritis: a real-life evidence from BioSTAR nationwide registry

Authors: Mehmet Tuncay Duruöz, Şebnem Ataman, Hatice Bodur, Hasan Fatih Çay, Meltem Alkan Melikoğlu, Özgür Akgül, Erhan Çapkın, Gülcan Gürer, Remzi Çevik, Feride Nur Göğüş, Ayhan Kamanlı, Fatma Gül Yurdakul, İlker Yağcı, Aylin Rezvani, Lale Altan

Published in: Rheumatology International | Issue 2/2024

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Abstract

Patients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular (CV) comorbidities. The association of CV diseases (CVD) and traditional CV risk factors has been debated, depending on patient and RA characteristics. This study aimed to find the prevalence of CVD and CV risk factors in patients with RA. A multi-center cross-sectional study was performed on RA patients using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry) in September 2022. Socio-demographic, clinical, and follow-up data were collected. Myocardial infarction, ischemic heart disease, peripheral vascular disorders, congestive heart failure, ischemic stroke, and transient ischemic attack were regarded as major adverse cardiovascular events (MACEs). CVD was defined as the presence of at least one clinical situation of MACE. Group 1 and Group 2 included patients with and without CVD. Prevalence rates of CVD and traditional CV risk factors were the primary outcomes. Secondary outcomes were the differences in the clinical characteristics between patients with and without CVD. An analysis of 724 patients with a mean age of 55.1 ± 12.8 years diagnosed with RA was conducted. There was a female preponderance (79.6%). The prevalence rate of CVD was 4.6% (n = 33). The frequencies of the diseases in the MACE category were ischemic heart disease in 27, congestive heart failure in five, peripheral vascular disorders in three, and cerebrovascular events in three patients. The patients with CVD (Group 1) were significantly male, older, and had higher BMI (p = 0.027, p < 0.001, and p = 0.041). Obesity (33.4%) and hypertension (27.2%) were the two CV risk factors most frequently. Male sex (HR = 7.818, 95% CI 3.030–20.173, p < 0.001) and hypertension (HR = 4.570, 95% CI 1.567–13.328, p = 0.005) were the independent risk factors for CVD. The prevalence of CVD in RA patients was 4.6%. Some common risk factors for CVD in the general population, including male sex, older age, and hypertension, were evident in RA patients. Male sex and hypertension were the independent risk factors for developing CVD in patients with RA.
Literature
2.
go back to reference Charles-Schoeman C, Buch MH, Dougados M, Bhatt DL, Giles JT, Ytterberg SR, Koch GG, Vranic I, Wu J, Wang C, Kwok K, Menon S, Rivas JL, Yndestad A, Connell CA, Szekanecz Z (2022) Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance. Ann Rheum Dis. https://doi.org/10.1136/ard-2022-222259CrossRefPubMed Charles-Schoeman C, Buch MH, Dougados M, Bhatt DL, Giles JT, Ytterberg SR, Koch GG, Vranic I, Wu J, Wang C, Kwok K, Menon S, Rivas JL, Yndestad A, Connell CA, Szekanecz Z (2022) Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance. Ann Rheum Dis. https://​doi.​org/​10.​1136/​ard-2022-222259CrossRefPubMed
3.
go back to reference Yu KH, Chen HH, Cheng TT, Jan YJ, Weng MY, Lin YJ, Chen HA, Cheng JT, Huang KY, Li KJ, Su YJ, Leong PY, Tsai WC, Lan JL, Chen DY (2022) Consensus recommendations on managing the selected comorbidities including cardiovascular disease, osteoporosis, and interstitial lung disease in rheumatoid arthritis. Medicine (Baltimore) 101(1):e28501. https://doi.org/10.1097/MD.0000000000028501CrossRefPubMed Yu KH, Chen HH, Cheng TT, Jan YJ, Weng MY, Lin YJ, Chen HA, Cheng JT, Huang KY, Li KJ, Su YJ, Leong PY, Tsai WC, Lan JL, Chen DY (2022) Consensus recommendations on managing the selected comorbidities including cardiovascular disease, osteoporosis, and interstitial lung disease in rheumatoid arthritis. Medicine (Baltimore) 101(1):e28501. https://​doi.​org/​10.​1097/​MD.​0000000000028501​CrossRefPubMed
12.
go back to reference Ytterberg SR, Bhatt DL, Mikuls TR, Koch GG, Fleischmann R, Rivas JL, Germino R, Menon S, Sun Y, Wang C, Shapiro AB, Kanik KS, Connell CA (2022) ORAL surveillance investigators. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med 386(4):316–326. https://doi.org/10.1056/NEJMoa2109927CrossRefPubMed Ytterberg SR, Bhatt DL, Mikuls TR, Koch GG, Fleischmann R, Rivas JL, Germino R, Menon S, Sun Y, Wang C, Shapiro AB, Kanik KS, Connell CA (2022) ORAL surveillance investigators. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med 386(4):316–326. https://​doi.​org/​10.​1056/​NEJMoa2109927CrossRefPubMed
13.
go back to reference Guerra JD, De Santiago AB, Reed S, Hammonds KP, Shaver C, Widmer RJ, Scholz BA (2022) Cardiology co-management of rheumatoid arthritis patients with coronary artery disease as an intervention reduces hospitalization rates and adverse event occurrence. Clin Rheumatol 16:1–10. https://doi.org/10.1007/s10067-022-06335-4CrossRef Guerra JD, De Santiago AB, Reed S, Hammonds KP, Shaver C, Widmer RJ, Scholz BA (2022) Cardiology co-management of rheumatoid arthritis patients with coronary artery disease as an intervention reduces hospitalization rates and adverse event occurrence. Clin Rheumatol 16:1–10. https://​doi.​org/​10.​1007/​s10067-022-06335-4CrossRef
14.
go back to reference Wen P, Luo P, Zhang B, Wang Y, Hao L, Wang J, Guo J, Liu R, Zhang Y, Chen J (2022) Hotspots and future directions in rheumatoid arthritis-related cardiovascular disease: a scientometric and visualization study from 2001 to 2021 based on Web of Science. Front Med (Lausanne) 29(9):931626. https://doi.org/10.3389/fmed.2022.931626CrossRef Wen P, Luo P, Zhang B, Wang Y, Hao L, Wang J, Guo J, Liu R, Zhang Y, Chen J (2022) Hotspots and future directions in rheumatoid arthritis-related cardiovascular disease: a scientometric and visualization study from 2001 to 2021 based on Web of Science. Front Med (Lausanne) 29(9):931626. https://​doi.​org/​10.​3389/​fmed.​2022.​931626CrossRef
15.
go back to reference Delcoigne B, Ljung L, Provan SA, Glintborg B, Hetland ML, Grøn KL, Peltomaa R, Relas H, Turesson C, Gudbjornsson B, Michelsen B, Askling J (2022) Short-term, intermediate-term and long-term risks of acute coronary syndrome in cohorts of patients with RA starting biologic DMARDs: results from four Nordic countries. Ann Rheum Dis 81(6):789–797. https://doi.org/10.1136/annrheumdis-2021-221996CrossRefPubMed Delcoigne B, Ljung L, Provan SA, Glintborg B, Hetland ML, Grøn KL, Peltomaa R, Relas H, Turesson C, Gudbjornsson B, Michelsen B, Askling J (2022) Short-term, intermediate-term and long-term risks of acute coronary syndrome in cohorts of patients with RA starting biologic DMARDs: results from four Nordic countries. Ann Rheum Dis 81(6):789–797. https://​doi.​org/​10.​1136/​annrheumdis-2021-221996CrossRefPubMed
19.
go back to reference Ataman S, Sunar I, Bodur H, Melikoglu MA, Cay HF, Capkin E, Akgul O, Cevik R, Gogus F, Kamanli A, Yurdakul FG, Gurer G, Yagci I, Rezvani A, Duruoz MT (2022) Demographic and clinical characteristics of patients with sustained and switching treatments using biological and targeted synthetic disease-modifying antirheumatic drugs: a multicenter, observational cross-sectional study for rheumatoid arthritis. Rheumatol Ther 9(1):223–241. https://doi.org/10.1007/s40744-021-00403-yCrossRefPubMed Ataman S, Sunar I, Bodur H, Melikoglu MA, Cay HF, Capkin E, Akgul O, Cevik R, Gogus F, Kamanli A, Yurdakul FG, Gurer G, Yagci I, Rezvani A, Duruoz MT (2022) Demographic and clinical characteristics of patients with sustained and switching treatments using biological and targeted synthetic disease-modifying antirheumatic drugs: a multicenter, observational cross-sectional study for rheumatoid arthritis. Rheumatol Ther 9(1):223–241. https://​doi.​org/​10.​1007/​s40744-021-00403-yCrossRefPubMed
20.
go back to reference Frisell T, Bower H, Morin M, Baecklund E, Di Giuseppe D, Delcoigne B, Feltelius N, Forsblad-d’Elia H, Lindqvist E, Lindström U, Askling J (2023) ARTIS Study group. Safety of biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis as used in clinical practice: results from the ARTIS programme. Ann Rheum Dis 82(5):601–610. https://doi.org/10.1136/ard-2022-223762CrossRefPubMed Frisell T, Bower H, Morin M, Baecklund E, Di Giuseppe D, Delcoigne B, Feltelius N, Forsblad-d’Elia H, Lindqvist E, Lindström U, Askling J (2023) ARTIS Study group. Safety of biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis as used in clinical practice: results from the ARTIS programme. Ann Rheum Dis 82(5):601–610. https://​doi.​org/​10.​1136/​ard-2022-223762CrossRefPubMed
21.
go back to reference Almoallim H, Hassan R, Cheikh M, Faruqui H, Alquraa R, Eissa A, Alhazmi A, Alsolaimani R, Janoudi N (2020) Rheumatoid arthritis saudi database (RASD): disease characteristics and remission rates in a tertiary care center. Open Access Rheumatol 6(12):139–145. https://doi.org/10.2147/OARRR.S260426CrossRef Almoallim H, Hassan R, Cheikh M, Faruqui H, Alquraa R, Eissa A, Alhazmi A, Alsolaimani R, Janoudi N (2020) Rheumatoid arthritis saudi database (RASD): disease characteristics and remission rates in a tertiary care center. Open Access Rheumatol 6(12):139–145. https://​doi.​org/​10.​2147/​OARRR.​S260426CrossRef
23.
go back to reference Melikoglu MA, Ataman S, Bodur H, Cay HF, Capkin E, Akgul O, Cevik R, Gogus F, Kamanli A, Yurdakul FG, Gurer G, Yagci I, Rezvani A, Duruoz MT, Sunar I (2021) Clinical performance of rheumatoid arthritis impact of disease score: a real-life evidence from the multicenter nationwide registry BioSTAR. Rheumatol Int 41(11):1971–1978. https://doi.org/10.1007/s00296-021-04992-3CrossRefPubMed Melikoglu MA, Ataman S, Bodur H, Cay HF, Capkin E, Akgul O, Cevik R, Gogus F, Kamanli A, Yurdakul FG, Gurer G, Yagci I, Rezvani A, Duruoz MT, Sunar I (2021) Clinical performance of rheumatoid arthritis impact of disease score: a real-life evidence from the multicenter nationwide registry BioSTAR. Rheumatol Int 41(11):1971–1978. https://​doi.​org/​10.​1007/​s00296-021-04992-3CrossRefPubMed
24.
26.
go back to reference Gossec L, Paternotte S, Aanerud GJ, Balanescu A, Boumpas DT, Carmona L, de Wit M, Dijkmans BA, Dougados M, Englbrecht M, Gogus F, Heiberg T, Hernandez C, Kirwan JR, Mola EM, Cerinic MM, Otsa K, Schett G, Scholte-Voshaar M, Sokka T, von Krause G, Wells GA, Kvien TK (2011) Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative. Ann Rheum Dis 70(6):935–942. https://doi.org/10.1136/ard.2010.142901CrossRefPubMed Gossec L, Paternotte S, Aanerud GJ, Balanescu A, Boumpas DT, Carmona L, de Wit M, Dijkmans BA, Dougados M, Englbrecht M, Gogus F, Heiberg T, Hernandez C, Kirwan JR, Mola EM, Cerinic MM, Otsa K, Schett G, Scholte-Voshaar M, Sokka T, von Krause G, Wells GA, Kvien TK (2011) Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative. Ann Rheum Dis 70(6):935–942. https://​doi.​org/​10.​1136/​ard.​2010.​142901CrossRefPubMed
30.
go back to reference Küçükdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A (2004) Issues in cross-cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum 51(1):14–19. https://doi.org/10.1002/art.20091CrossRefPubMed Küçükdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A (2004) Issues in cross-cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum 51(1):14–19. https://​doi.​org/​10.​1002/​art.​20091CrossRefPubMed
31.
32.
go back to reference Raadsen R, Agca R, Boers M, van Halm VP, Peters MJL, Smulders Y, Beulens JWJ, Blom MT, Stehouwer CDA, Voskuyl AE, Lems WF, Nurmohamed MT (2022) In RA patients without prevalent CVD, incident CVD is mainly associated with traditional risk factors: a 20-year follow-up in the CARRÉ cohort study. Semin Arthritis Rheum 12(58):152132. https://doi.org/10.1016/j.semarthrit.2022.152132CrossRef Raadsen R, Agca R, Boers M, van Halm VP, Peters MJL, Smulders Y, Beulens JWJ, Blom MT, Stehouwer CDA, Voskuyl AE, Lems WF, Nurmohamed MT (2022) In RA patients without prevalent CVD, incident CVD is mainly associated with traditional risk factors: a 20-year follow-up in the CARRÉ cohort study. Semin Arthritis Rheum 12(58):152132. https://​doi.​org/​10.​1016/​j.​semarthrit.​2022.​152132CrossRef
34.
go back to reference Dore RK, Antonova JN, Burudpakdee C, Chang L, Gorritz M, Genovese MC (2022) The incidence, prevalence, and associated costs of anemia, malignancy, venous thromboembolism, major adverse cardiovascular events, and infections in rheumatoid arthritis patients by treatment history in the United States. ACR Open Rheumatol 4(6):473–482. https://doi.org/10.1002/acr2.11376CrossRefPubMed Dore RK, Antonova JN, Burudpakdee C, Chang L, Gorritz M, Genovese MC (2022) The incidence, prevalence, and associated costs of anemia, malignancy, venous thromboembolism, major adverse cardiovascular events, and infections in rheumatoid arthritis patients by treatment history in the United States. ACR Open Rheumatol 4(6):473–482. https://​doi.​org/​10.​1002/​acr2.​11376CrossRefPubMed
36.
40.
go back to reference Vicente GNS, Pereira IA, de Castro GRW, da Mota LMH, Carnieletto AP, de Souza DGS, da Gama FO, Santos ABV, de Albuquerque CP, Bértolo MB, Júnior PL, Giorgi RDN, Radominski SC, Guimarães MFBR, Bonfiglioli KR, Sauma MFLDC, Brenol CV, da Rocha Castelar Pinheiro G (2021) Cardiovascular risk comorbidities in rheumatoid arthritis patients and the use of anti-rheumatic drugs: a cross-sectional real-life study. Adv Rheumatol 61(1):38. https://doi.org/10.1186/s42358-021-00186-4 Vicente GNS, Pereira IA, de Castro GRW, da Mota LMH, Carnieletto AP, de Souza DGS, da Gama FO, Santos ABV, de Albuquerque CP, Bértolo MB, Júnior PL, Giorgi RDN, Radominski SC, Guimarães MFBR, Bonfiglioli KR, Sauma MFLDC, Brenol CV, da Rocha Castelar Pinheiro G (2021) Cardiovascular risk comorbidities in rheumatoid arthritis patients and the use of anti-rheumatic drugs: a cross-sectional real-life study. Adv Rheumatol 61(1):38. https://​doi.​org/​10.​1186/​s42358-021-00186-4
43.
go back to reference Singh S, Fumery M, Singh AG, Singh N, Prokop LJ, Dulai PS, Sandborn WJ, Curtis JR (2020) Comparative risk of cardiovascular events with biologic and synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 72(4):561–576. https://doi.org/10.1002/acr.23875CrossRefPubMed Singh S, Fumery M, Singh AG, Singh N, Prokop LJ, Dulai PS, Sandborn WJ, Curtis JR (2020) Comparative risk of cardiovascular events with biologic and synthetic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 72(4):561–576. https://​doi.​org/​10.​1002/​acr.​23875CrossRefPubMed
45.
go back to reference Metsios GS, Moe RH, van der Esch M, van Zanten JJCSV, Fenton SAM, Koutedakis Y, Vitalis P, Kennedy N, Brodin N, Bostrom C, Swinnen TW, Tzika K, Niedermann K, Nikiphorou E, Fragoulis GE, Vlieland TPVM, Van den Ende CHM, Kitas GD, IMPACT-RMD Consortium (2020) The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis. Rheumatol Int 40(3):347–357. https://doi.org/10.1007/s00296-019-04483-6 Metsios GS, Moe RH, van der Esch M, van Zanten JJCSV, Fenton SAM, Koutedakis Y, Vitalis P, Kennedy N, Brodin N, Bostrom C, Swinnen TW, Tzika K, Niedermann K, Nikiphorou E, Fragoulis GE, Vlieland TPVM, Van den Ende CHM, Kitas GD, IMPACT-RMD Consortium (2020) The effects of exercise on cardiovascular disease risk factors and cardiovascular physiology in rheumatoid arthritis. Rheumatol Int 40(3):347–357. https://​doi.​org/​10.​1007/​s00296-019-04483-6
Metadata
Title
Prevalence of cardiovascular diseases and traditional cardiovascular risk factors in patients with rheumatoid arthritis: a real-life evidence from BioSTAR nationwide registry
Authors
Mehmet Tuncay Duruöz
Şebnem Ataman
Hatice Bodur
Hasan Fatih Çay
Meltem Alkan Melikoğlu
Özgür Akgül
Erhan Çapkın
Gülcan Gürer
Remzi Çevik
Feride Nur Göğüş
Ayhan Kamanlı
Fatma Gül Yurdakul
İlker Yağcı
Aylin Rezvani
Lale Altan
Publication date
29-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Rheumatology International / Issue 2/2024
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-023-05515-y

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