Newly developed cardiovascular risk factors in rheumatoid arthritis patients initiating biologic treatment

Autor: Wojciech Zaręba, Pior Krawiec, Małgorzata Banaszkiewicz, Krzysztof Batko, Aleksandra Gołąb, Dariusz Plicner, Zbigniew Żuber, Bogdan Batko
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Rheumatology, Vol 61, Iss 6, Pp 424-431 (2024)
Druh dokumentu: article
ISSN: 0034-6233
2084-9834
DOI: 10.5114/reum/176554
Popis: Introduction Rheumatoid arthritis (RA) is a risk factor (RF) for cardiovascular (CV) disease, a leading cause of mortality in RA patients. Material and methods Consecutive records of RA patients with high disease activity screened upon biologic therapy initiation were reviewed between January 2001 and 2018. Patients with at least 6-month follow-up and baseline disease activity scores were enrolled (n = 353) and stratified into manifest CV disorder (“overt CVD”), any traditional CV risk factor (“atCVrisk”) and no CV risk factor (“vlCVrisk”) groups. Results Overall, mean (SD) patient age was 51.4 (±12.2) years, and 291 (82.4%) subjects were female. Median follow-up was 41.9 (IQR 18.6, 80) months. Overall, 89 (25.2%) individuals developed at least one new CV RF, of which 65 (18.4%) acquired one and 24 (6.8%) two or more. Incident lipid disorders (42, 11.9%), followed by hypertension (14, 4%), atrial fibrillation (17, 4.8%) and venous thromboembolism (VTE) (16, 4.5%), were common. Incident major adverse cardiac events (MACE) were not reported in the vlCVrisk group, in contrast to atCVrisk ( n = 8, 4.2%) or overt CVD ( n = 4, 18.2%). Age was a significant predictor of incident CV risk factor (HR 1.04, 95% CI: 1.02–1.07; p < 0.01). In age-adjusted analyses, only baseline body mass index (BMI) (HR 1.11, 95% CI: 1.04–1.18; p < 0.01), but not ever smoking ( p = 0.93), male sex ( p = 0.26), positive RF ( p = 0.24), positive ACPA ( p = 0.90), or baseline disease activity ( p = 0.19), were independent predictor of incident CV risk factors. Conclusions Patients with RA initiating biologics should be screened for cardiometabolic risk factors, especially at an older age. The presence of at least one risk factor may be linked to a worse long-term prognosis.
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