Rheumatoid arthritis remission significantly cuts the risk for cardiovascular complications among patients with rheumatoid arthritis, according to a study presented at the recent European Congress of Rheumatology, the annual meeting of the European League Against Rheumatism, in Madrid.
In a prospective, observational study, Piero Ruscitti, from University of L’Aquila in Italy, and colleagues enrolled consecutive patients admitted to Italian rheumatology units with rheumatoid arthritis in 2015 and followed them for three years. The authors evaluated the occurrence of and possible predictive factors for subclinical (carotid and/or peripheral artery atherosclerotic lesions detected by ultrasound imaging) and clinical atherosclerosis (myocardial infarction and/or congestive heart failure and/or cerebrovascular accidents).
The final analysis included 797 patients (82.7 percent female; median age, 60 years; median RA duration, 8.35 years). The researchers observed that traditional cardiovascular risk factors included mean body mass index of 27.21 kg/m², smoking (33 percent), high blood pressure (49.3 percent), and type 2 diabetes (12.3 percent). Remission was achieved and maintained by 42.6 percent of patients during follow-up. There was an increased rate of subclinical atherosclerosis and clinical atherosclerosis at the end of follow-up. Type 2 diabetes (odds ratio [OR], 4.50), high blood pressure (OR, 2.03), anticitrullinated protein antibodies (OR, 2.36), and mean values of C-reactive protein (OR, 1.07) were associated with subclinical atherosclerosis, while diabetes was associated with clinical atherosclerosis (OR, 6.21). Maintenance of remission was associated with a reduced risk for subclinical atherosclerosis (OR, 0.25) and clinical atherosclerosis (OR, 0.20).
“Our study supports the idea that systemic inflammatory processes and more traditional cardiovascular risk factors work together to increase the cardiovascular risk in patients with rheumatoid arthritis,” Ruscitti said in a statement.
REFERENCE: European Congress of Rheumatology. https://www.congress.eular.org/