CVD risk greater among arthritic vs diabetic patients
The risk of cardiovascular (CV) disease (CVD) is significantly higher among patients with rheumatoid arthritis (RA) than those with type 2 diabetes (T2D), results of the CARRÉ* study reveal. Such risk persisted even after adjusting for traditional CV risk factors, which suggests that systemic inflammation is an independent contributor to CV risk.
Of note, the incidence rate of CV events in established RA was twofold higher than that of the general population, the authors said.
Of the 353 patients with RA, 95 developed a CV event over 2,973 person-years, resulting in an incidence rate of 3.20 per 100 person-years. In the reference cohort, 257 CV events were reported, with an incidence rate of 1.36 per 100 person-years.
Compared with nondiabetic participants, those with RA (hazard ratio [HR], 2.07, 95 percent confidence interval [CI], 1.57–2.72; p<0.01) and T2D (HR, 1.51, 95 percent CI, 1.02–2.22; p=0.04) had higher odds of experiencing CV events, after adjustment for age and sex. The risk remained elevated in RA patients (HR, 1.82, 95 percent CI, 1.32–2.50; p<0.01) after additional adjustment for CV risk factors.
The odds of developing CVD were highest among patients with both RA and T2D or insulin resistance (HR, 2.21, 95 percent CI, 1.01–4.80; p=0.046; and HR, 2.67, 95 percent CI, 1.30–5.46; p<0.01, respectively).
The CARRÉ study is a prospective cohort study examining CVD and its risk factors in patients with longstanding RA. The investigators assessed CV endpoints at baseline and at 3, 10 and 15 years after the start of the study. They also compared these outcomes with those from a reference cohort (n=2,540), including several patients with T2D.
*CARdiovascular research and RhEumatoid arthritis