Risk of heart attack in patients
Rheumatoid Arthritis (RA) patients face a two-fold increased risk of suffering a Myocardial Infarction (MI, heart attack) versus the general population, which is comparable to the increased risk of MI seen in diabetes patients, according to results of a new study presented today at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy.
In this Danish, nationwide, 10 year study, RA and diabetes patients were directly compared to assess their individual risk of having an MI over time. In those patients that developed RA, the Incidence Rate Ratio (IRR) of experiencing a MI was increased to 1.65 (95% Confidence Interval (CI) 1.46-1.86), comparable to the increased risk of MI seen in patients developing diabetes mellitus (IRR 1.73 95% CI (1.68-1.79)). Data was further analysed to examine increased risk in certain age groups and researchers found that the risk of MI was increased six-fold in women with RA younger than 50 years (IRR 6.01 95% CI (3.62-9.99)) comparable to diabetic women in the same age range (IRR 6.13 95% CI (4.99-7.54)). Overall, the risk of MI in patients with RA and diabetes was similar for male patients at IRR 1.66 (1.39-1.98) and 1.59 (1.53-1.66) respectively.
"While we already know that RA is an independent risk factor for cardiovascular disease, our data highlight that the increased risk of a heart attack faced by RA patients is of a similar magnitude as that faced by diabetes patients, who in contrast to RA patients are routinely considered for intensive cardiovascular risk management," said Dr. Jesper Lindhardsen, Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark, and lead author of the study. "This study underlines the importance of implementing EULAR recommendations advocating early detection and management of cardiovascular risk factors, as well as providing sufficient RA treatment in order to reduce the significant burden associated with cardiovascular disease co-morbidity and mortality."
The study, which was supported by the Danish Rheumatism Association, analysed data from the entire Danish population (n=4,614,840, minimum 10 years old) and monitored for incidence of diabetes and RA between 1997 and 2006 (or the date of patients first MI, whichever came first). A total of 10,547 people developed RA and 132,868 developed diabetes. IRR was calculated and analysed by multiple Poisson regression, a statistical technique utilised for modeling and analyzing several variables in a patient population.