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Martín-Martínez MA, Castañeda S, Sánchez-Alonso F, García-Gómez C, González-Juanatey C, Sánchez-Costa JT, Belmonte-López MA, Tornero-Molina J, Santos-Rey J, Sánchez González CO, Quesada E, Moreno-Gil MP, Cobo-Ibáñez T, Pinto-Tasnde JA, Babío-Herráez J, Bonilla G, Juan-Mas A, Manero-Ruiz FJ, Romera-Baurés M, Bachiller-Corral J, Chamizo-Carmona E, Uriarte-Ecenarro M, Barbadillo C, Fernández-Carballido C, Aurrecoechea E, Möller-Parrera I, Llorca J, González-Gay MA. Cardiovascular mortality and cardiovascular event rates in patients with inflammatory rheumatic diseases in the CARdiovascular in rheuMAtology (CARMA) prospective study—results at 5 years of follow-up. Rheumatology (Oxford) 2020; 60:2906-2915. [DOI: 10.1093/rheumatology/keaa737] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/21/2020] [Indexed: 12/22/2022] Open
Abstract
Abstract
Objectives
To determine cardiovascular (CV) mortality and incidence of the first CV event (CVE) in patients with chronic inflammatory rheumatic diseases (CIRD) after 5 years of follow-up.
Methods
This is an analysis of the CARdiovascular in rheMAatology (CARMA) study after 5 years of follow-up. It includes patients with RA (n = 775), AS (n = 738) and PsA (n = 721), and individuals without CIRD (n = 677) attending outpatient rheumatology clinics from 67 public hospitals in Spain. Descriptive analyses were performed for the CV mortality at 5 years. The Systematic COronary Risk Evaluation (SCORE) function at 5 years was calculated to determine the expected risk of CV mortality. Poisson models were used to estimate the incidence rates of the first CVE. Hazard ratios of the risk factors involved in the development of the first CVE were evaluated using the Weibull proportional hazard model.
Results
Overall, 2382 subjects completed the follow-up visit at 5 years. Fifteen patients died due to CVE. CV deaths observed in the CIRD cohort were lower than that predicted by SCORE risk charts. The highest incidence rate of CVE [7.39 cases per 1000 person-years (95% CI 4.63, 11.18)] was found in PsA patients. However, after adjusting for age, sex and CV risk factors, AS was the inflammatory disease more commonly associated with CVE at 5 years [hazard ratio 4.60 (P =0.02)], compared with those without CIRD.
Conclusions
Cardiovascular mortality in patients with CIRD at 5 years of follow-up is lower than estimated. Patients with AS have a higher risk of developing a first CVE after 5 years of follow-up.
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Affiliation(s)
| | - Santos Castañeda
- Division of Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain
- Cátedra UAM-ROCHE, EPID-Future, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | | | - Carmen García-Gómez
- Division of Rheumatology, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
| | | | | | | | - Jesús Tornero-Molina
- Division of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - José Santos-Rey
- Division of Rheumatology, Hospital Virgen de la Salud, Toledo, Spain
| | | | - Estefanía Quesada
- Division of Rheumatology, Hospital Universitario Vall D’Hebron, Barcelona, Spain
| | - María P Moreno-Gil
- Division of Rheumatology, Complejo Hospitalario de Cáceres, Cáceres, Spain
| | - Tatiana Cobo-Ibáñez
- Division of Rheumatology, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - José A Pinto-Tasnde
- Division of Rheumatology, Complejo Hospitalario Universitario A Coruña, Spain
| | | | - Gema Bonilla
- Division of Rheumatology, Hospital Universitario de La Paz, Madrid, Spain
| | - Antonio Juan-Mas
- Division of Rheumatology, Hospital Sont Llatzer, Palma de Mallorca, Spain
| | | | | | | | | | - Mirem Uriarte-Ecenarro
- Division of Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa, Madrid, Spain
| | - Carmen Barbadillo
- Division of Rheumatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | - Elena Aurrecoechea
- Division of Rheumatology, Hospital U. Sierrallana, Torrelavega, Santander, Spain
| | | | - Javier Llorca
- Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria and CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain
| | - Miguel A González-Gay
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain, Spain
- School of Physiology, Faculty of Health Sciences, Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, South Africa
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