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Thromb Haemost 2016; 115(02): 439-445
DOI: 10.1160/th15-07-0600
DOI: 10.1160/th15-07-0600
Atherosclerosis and Ischaemic Disease
Risk of peripheral arterial occlusive disease in patients with rheumatoid arthritis
A nationwide population-based cohort studyFinancial support: This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW104-TDU-B-212–113002); China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM104010092); NRPB Stroke Clinical Trial Consortium (MOST 103–2325-B-039–006); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.
Weitere Informationen
Publikationsverlauf
Received:
30. Juli 2015
Accepted after major revision:
04. September 2015
Publikationsdatum:
22. November 2017 (online)
Summary
Rheumatoid arthritis (RA) is associated with atherosclerosis. However, the relationship between RA and peripheral arterial occlusive disease (PAOD) remains unclear. We used a national health insurance database to identify a cohort of 30,812 patients diagnosed with RA between 2000 and 2011. Each RA patient was frequency-matched according to age and sex with a patient without RA from a control cohort. A multivariate Cox proportional hazards model was used to analyse the adjusted risk of PAOD. The incidence of PAOD was 1.73-fold higher (95 % confidence interval [CI] = 1.57–1.91) in the RA cohort than in the non-RA cohort. The adjusted risk of PAOD was the highest in the patients with RA aged ≤ 49 years (hazard ratio [HR] = 3.39, 95 % CI = 2.66–4.32). Patients with RA and various comorbidities showed a significantly higher risk of PAOD (HR = 9.62, 95 % CI = 4.86–19.1) compared with control patients without comorbidity. The risk of PAOD increased during the first year of follow-up. In conclusion, patients with RA have an independently higher risk of PAOD compared with the general population. Patients with RA and various comorbidities and those at a young age and early stage of the disease have an increased risk of PAOD.
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References
- 1 Grisar J, Aletaha D, Steiner CW. et al. Depletion of endothelial progenitor cells in the peripheral blood of patients with rheumatoid arthritis. Circulation 2005; 111: 204-211.
- 2 Sattar N, McCarey DW, Capell H. et al. Explaining how high-grade” systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 2003; 108: 2957-2963.
- 3 Mason JC, Libby P. Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumato-logic conditions. Eur Heart J 2015; 36: 482-489c.
- 4 de Groot L, Jager NA, Westra J. et al. Does reduction of disease activity improve early markers of cardiovascular disease in newly diagnosed rheumatoid arthritis patients?. Rheumatology 2015; 54: 1257-1261.
- 5 del Rincón ID, Williams K, Stern MP. et al. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum 2001; 44: 2737-2745.
- 6 Solomon DH, Kremer J, Curtis JR. et al. Explaining the cardiovascular risk associated with rheumatoid arthritis: traditional risk factors versus markers of rheumatoid arthritis severity. Ann Rheum Dis 2010; 69: 1920-1925.
- 7 Stamatelopoulos KS, Kitas GD, Papamichael CM. et al. Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study. Arterioscler Thromb Vasc Biol 2009; 29: 1702-1708.
- 8 Peters MJ, van Halm VP, Voskuyl AE. et al. Does rheumatoid arthritis equal diabetes mellitus as an independent risk factor for cardiovascular disease? A prospective study. Arthritis Rheum 2009; 61: 1571-1579.
- 9 van Halm VP, Peters MJ, Voskuyl AE. et al. Rheumatoid arthritis versus diabetes as a risk factor for cardiovascular disease: a cross-sectional study, the CARRE Investigation. Ann Rheum Dis 2009; 68: 1395-1400.
- 10 Wallberg-Jonsson S, Ohman ML, Dahlqvist SR. Dahlqvist, Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in Northern Sweden. J Rheumatol 1997; 24: 445-451.
- 11 Solomon DH, Karlson EW, Rimm EB. et al. Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 2003; 107: 1303-1307.
- 12 Gonzalez A, Maradit Kremers H, Crowson CS. et al. Do cardiovascular risk factors confer the same risk for cardiovascular outcomes in rheumatoid arthritis patients as in non-rheumatoid arthritis patients?. Ann Rheum Dis 2008; 67: 64-69.
- 13 Baghdadi LR, Woodman RJ, Shanahan EM. et al. The impact of traditional cardiovascular risk factors on cardiovascular outcomes in patients with rheumatoid arthritis: a systematic review and meta-analysis. PLoS One 2015; 10: e0117952.
- 14 Boyer JF, Gourraud PA, Cantagrel A. et al. Traditional cardiovascular risk factors in rheumatoid arthritis: a meta-analysis. Joint Bone Spine 2011; 78: 179-183.
- 15 Maradit-Kremers H, Crowson CS, Nicola PJ. et al. Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum 2005; 52: 402-411.
- 16 Nicola PJ, Maradit-Kremers H, Roger VL. et al. The risk of congestive heart failure in rheumatoid arthritis: a population-based study over 46 years. Arthritis Rheum 2005; 52: 412-420.
- 17 Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation 2004; 110: 738-743.
- 18 He Y, Jiang Y, Wang J. et al. Prevalence of peripheral arterial disease and its association with smoking in a population-based study in Beijing, China. J Vasc Surg 2006; 44: 333-338.
- 19 Carvounis CP, Nikas N. Prevalence of peripheral arterial disease in subjects at moderate cardiovascular risk: Greek results of the PANDORA study. Hellenic J Cardiol 2014; 55: 294-304.
- 20 Chen YJ, Lin MS, Hsu KY. et al. Prevalence of asymptomatic peripheral arterial disease and related risk factors in younger and elderly patients in Taiwan. Angi-ology 2014; 65: 396-401.
- 21 Mourad JJ, Cacoub P, Collet JP. et al. Screening of unrecognized peripheral arterial disease (PAD) using ankle-brachial index in high cardiovascular risk patients free from symptomatic PAD. J Vasc Surg 2009; 50: 572-580.
- 22 del Rincón I, Haas RW, Pogosian S. et al. Lower limb arterial incompressibility and obstruction in rheumatoid arthritis. Ann Rheum Dis 2005; 64: 425-432.
- 23 Hafner J, Schneider E, Burg G. et al. Management of leg ulcers in patients with rheumatoid arthritis or systemic sclerosis: the importance of concomitant arterial and venous disease. J Vasc Surg. 2000; 32: 322-329.
- 24 Liang KP, Liang KV, Matteson EL. et al. Incidence of noncardiac vascular disease in rheumatoid arthritis and relationship to extraarticular disease manifestations. Arthritis Rheum 2006; 54: 642-648.
- 25 Henke PK, Sukheepod P, Proctor MC. et al. Clinical relevance of peripheral vascular occlusive disease in patients with rheumatoid arthritis and systemic lupus erythematosus. J Vasc Surg 2003; 38: 111-115.
- 26 Stamatelopoulos KS, Kitas GD, Papamichael CM. et al. Subclinical peripheral arterial disease in rheumatoid arthritis. Atherosclerosis 2010; 212: 305-309.
- 27 Lin CS, Chen SJ, Sung CC. et al. Hemodialysis Is Associated With Increased Peripheral Artery Occlusive Disease Risk Among Patients With End-Stage Renal Disease: A Nationwide Population-Based Cohort Study. Medicine 2015; 94: e1164.
- 28 Shen CH, Lin TY, Huang WY. et al. Pneumoconiosis increases the risk of peripheral arterial disease: a nationwide population-based study. Medicine 2015; 94: e911.
- 29 Chou TY, Su TW, Jou HJ. et al. Increased risk of peripheral arterial disease after hip replacement: an 11-year retrospective population-based cohort study. Medicine 2015; 94: e870.
- 30 Kurt T, Temiz A, Gokmen F. et al. Can the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) be new early stage markers of sub-clinical atherosclerosis in patients with rheumatoid arthritis?. Wien Klin Wo-chenschr. 2015 Epub ahead of print.
- 31 Solomon DH, Goodson NJ, Katz JN. et al. Patterns of cardiovascular risk in rheumatoid arthritis. Ann Rheum Dis 2006; 65: 1608-1612.
- 32 Innala L, Möller B, Ljung L. et al. Cardiovascular events in early RA are a result of inflammatory burden and traditional risk factors: a five year prospective study. Arthritis Res Ther 2011; 13: R131.
- 33 Södergren A, Karp K, Boman K. et al. Atherosclerosis in early rheumatoid arthritis: very early endothelial activation and rapid progression of intima media thickness. Arthritis Res Ther 2010; 12: R158.
- 34 Chatterjee Adhikari M, Guin A, Chakraborty S. et al. Subclinical atherosclerosis and endothelial dysfunction in patients with early rheumatoid arthritis as evidenced by measurement of carotid intima-media thickness and flow-mediated va-sodilatation: an observational study. Semin Arthritis Rheum 2012; 41: 669-675.
- 35 Georgiadis AN, Voulgari PV, Argyropoulou MI. et al. Early treatment reduces the cardiovascular risk factors in newly diagnosed rheumatoid arthritis patients. Semin Arthritis Rheum 2008; 38: 13-19.
- 36 Naranjo A, Sokka T, Descalzo MA. et al. Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study. Arthritis Res Ther 2008; 10: R30.
- 37 Roubille C, Richer V, Starnino T. et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticoste-roids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis 2015; 74: 480-489.
- 38 Mirjafari H, Al-Husain A, Bruce IN. Bruce, Cardiovascular risk factors in inflammatory arthritis. Curr Opin Lipidol 2011; 22: 296-301.
- 39 Arida A, Zampeli E, Konstantonis G. et al. Rheumatoid arthritis is sufficient to cause atheromatosis but not arterial stiffness or hypertrophy in the absence of classical cardiovascular risk factors. Clin Rheumatol 2015; 34: 853-859.
- 40 Kremers HM, Crowson CS, Therneau TM. et al. High ten-year risk of cardiovascular disease in newly diagnosed rheumatoid arthritis patients: a population-based cohort study. Arthritis Rheum 2008; 58: 2268-2274.
- 41 Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res. 2015; 116: 1509-1526.
- 42 Santos MJ, Vinagre F, Silva JJ. et al. Cardiovascular risk profile in systemic lupus erythematosus and rheumatoid arthritis: a comparative study of female patients. Acta Reumatol Port 2010; 35: 325-332.
- 43 Yeh CC, Wang HH, Chou YC. et al. High risk of gastrointestinal hemorrhage in patients with epilepsy: a nationwide cohort study. Mayo Clin Proc 2013; 88: 1091-1098.