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Increased occurrence of cardiovascular events and comorbidities in a general rheumatology cohort

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Abstract

Background

To identify cardiovascular and other comorbidities in a general rheumatology cohort.

Methods

Interviews/retrospective chart audits were conducted on 1,000 patients attending rheumatology outpatient clinics of a university teaching hospital. Comorbidities were classified using the Charlson comorbidity index (Ambrose et al. in Ir J Med Sci 178(1):53–55, 2009).

Results

Mean age 58 ± 15.3 years, mean BMI 26. Of the patients, 400 (40%) were diagnosed with dyslipidemia and hypertension (p = 0.002), 160 (16%) with obesity and 80 (8%) with hypothyroidism. Overall 160 (16%) patients were diagnosed with coronary heart disease (CHD). Of these, 120 (75%) had RA (p = 0.001), 100 (63%) were male, mean age 60 ± 15.8 years, 120 (75%) had dyslipidemia and BMI > 30 (p = 0.002), 112 (70%) were smokers (p = 0.002), 40 (25%) were diagnosed with diabetes mellitus and 20 (12%) with hypothyroidism.

Conclusions

The increased prevalence of these comorbidities may serve as a reminder to the rheumatologists that many of their patients will have coexistent disease of which they need to be aware to properly plan their management.

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References

  1. Khanna R, Smith MJ (2007) Utilization and costs of medical services and prescription medications for rheumatoid arthritis among recipients covered by a state medicaid program: a retrospective, cross-sectional, descriptive, database analysis. Clin Ther 29(11):2456–2467

    Article  PubMed  Google Scholar 

  2. Kavanaugh A (2007) Economic consequences of established rheumatoid arthritis and its treatment. Best Pract Res Clin Rheumatol 21(5):929–942

    Article  PubMed  Google Scholar 

  3. Pincus T (2007) Patient questionnaires and formal education as more significant prognostic markers than radiographs or laboratory tests for rheumatoid arthritis mortality—limitations of a biomedical model to predict long-term outcomes. Bull NYU Hosp Jt Dis 65(Suppl 1):S29–S36

    PubMed  Google Scholar 

  4. Dhawan SS, Quyyumi AA (2008) Rheumatoid arthritis and cardiovascular disease. Curr Atheroscler Rep 10(2):128–133

    Article  CAS  PubMed  Google Scholar 

  5. El-Magadmi M, Bodill H, Ahmad Y et al (2004) Systemic lupus erythematosus: an independent risk factor for endothelial dysfunction in women. Circulation 110(4):399–404

    Article  PubMed  Google Scholar 

  6. Choe JY, Lee MY, Rheem I, Rhee MY, Park SH, Kim SK (2008) No differences of carotid intima–media thickness between young patients with ankylosing spondylitis and healthy controls. Jt Bone Spine 75:548–553

    Article  CAS  Google Scholar 

  7. Ambrose NL, O’Connell P, Kearns G (2009) Limiting cardiovascular risk in Irish rheumatoid arthritis patients. Ir J Med Sci 178(1):53–55

    Article  CAS  PubMed  Google Scholar 

  8. Charlson M, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  CAS  PubMed  Google Scholar 

  9. McKee PA, Castelli WP, McNamara PM et al (1971) The natural history of congestive heart failure: the Framingham study. N Engl J Med 285:1441–1446

    Article  CAS  PubMed  Google Scholar 

  10. Spencer CA (1988) Clinical utility, cost-effectiveness of sensitive thyrotropin assays in ambulatory, hospitalized patients. Mayo Clin Proc 63:1214

    CAS  PubMed  Google Scholar 

  11. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486–2497

    Google Scholar 

  12. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications I. Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553

    Article  CAS  PubMed  Google Scholar 

  13. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997;157:2413–2446

    Google Scholar 

  14. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 1998;158:1855–1867

  15. Dytham C (2003) Choosing and using statistics: a biologist’s guide, 2nd edn. Blackwell, Oxford

  16. World Health Organization (1994) Assessment of fracture risk and its application to screening for post menopausal osteoporosis. WHO technical report series 843, WHO, Geneva

  17. Nicola PJ, Crowson CS, Maradit-Kremers H et al (2006) Contribution of congestive heart failure and ischemic heart disease to excess mortality in rheumatoid arthritis. Arthritis Rheum 54(1):60–67

    Article  PubMed  Google Scholar 

  18. Gonzalez A, Maradit Kremers H, Crowson CS et al (2008) Do cardiovascular risk factors confer the same risk for cardiovascular outcomes in rheumatoid arthritis patients as in non-rheumatoid arthritis patients? Ann Rheum Dis 67(1):64–69

    Article  CAS  PubMed  Google Scholar 

  19. Dessein PH, Norton GR, Woodiwiss AJ et al (2007) Influence of nonclassical cardiovascular risk factors on the accuracy of predicting subclinical atherosclerosis in rheumatoid arthritis. J Rheumatol 34(5):943–951

    PubMed  Google Scholar 

  20. Loza E, Jover JA, Rodriguez-Rodriguez L, EPISER Study Group et al (2008) Observed and expected frequency of comorbid chronic diseases in rheumatic patients. Ann. Rheum Dis 67(3):418–421

    Article  CAS  Google Scholar 

  21. Raterman HG, van Halm VP, Voskuyl AE et al (2008) Rheumatoid arthritis is associated with a high prevalence of hypothyroidism which amplifies its cardiovascular risk. Ann Rheum Dis 67:229–232

    Article  CAS  PubMed  Google Scholar 

  22. Keystone EC (2006) Strategies to control disease in rheumatoid arthritis with tumor necrosis factor antagonists-an opportunity to improve outcomes. Nat Clin Pract Rheumatol 2(11):594–601

    Article  CAS  PubMed  Google Scholar 

  23. Choi HK, Hernan MA, Seeger JD et al (2002) Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet 359:1173–1177

    Article  CAS  PubMed  Google Scholar 

  24. Van Halm VP, Nurmohamed MT, Twisk JW et al (2006) Disease-modifying antirheumatic drugs are associated with a reduced risk for cardiovascular disease in patients with rheumatoid arthritis: a case control study. Arthritis Res Ther 8(5):R151

    Article  PubMed  CAS  Google Scholar 

  25. García Rodríguez LA, Barreales Tolosa L (2007) Risk of upper gastrointestinal complications among users of traditional NSAIDs and COXIBs in the general population. Gastroenterology 132(2):498–506

    Article  PubMed  CAS  Google Scholar 

  26. Lazzaroni M, Battocchia A, Bianchi Porro G (2007) COXIBs and non-selective NSAIDs in the gastroenterological setting: what should patients and physicians do? Dig Liver Dis 39(6):589–596

    Article  CAS  PubMed  Google Scholar 

  27. Sinigaglia L, Varenna M, Girasole G et al (2006) Epidemiology of osteoporosis in rheumatic diseases. Rheum Dis Clin North Am 32(4):631–658

    Article  PubMed  Google Scholar 

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Correspondence to A. Mohammad.

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Mohammad, A., Hartery, K., Bond, U. et al. Increased occurrence of cardiovascular events and comorbidities in a general rheumatology cohort. Ir J Med Sci 179, 273–276 (2010). https://doi.org/10.1007/s11845-010-0475-5

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  • DOI: https://doi.org/10.1007/s11845-010-0475-5

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