Archives of General Internal Medicine

Journal Banner

Assessment of Cardiovascular Disease in Rheumatoid Arthritis Patients

Introduction: The risk of cardiovascular disease is increased in patients with rheumatoid arthritis. Previous studies have compared cardiovascular disease risk factors between patients with and without rheumatoid arthritis, but none have compared rheumatoid arthritis patients with and without cardiovascular disease. To compare rheumatoid arthritis patients with and without cardiovascular disease in addition to cardiovascular disease patients without rheumatoid arthritis.

Methods: Retrospective cross sectional study from 2011-2014 of rheumatology, cardiology, internal medicine, and family medicine clinics at a multi-site academic medical center.

Participants: Rheumatoid arthritis patients had the international classification of disease code “rheumatoid arthritis”. Cardiovascular disease patients had at least one of following codes: peripheral artery disease, coronary artery disease, diabetes, stroke, abdominal aortic aneurysm, transient ischemic attack, or myocardial infarction. All eligible patients were included in the study. Patients were divided into three groups: 2,305 patients with only rheumatoid arthritis, 276 patients with rheumatoid arthritis and cardiovascular disease, and 13,473 patients with only cardiovascular disease. Descriptive statistics was performed.

Results: Only 11,490 (72%) of patients had a full lipid panel available. However, patients with and without a full lipid panel did not differ in age, gender, smoking status, body mass index, or systolic and diastolic blood pressure. Patients with only rheumatoid arthritis had low density lipoprotein levels 19% higher than patients with rheumatoid arthritis and cardiovascular disease (p<0.001, 95% CI: [1.10, 1.28],) and 16% greater than patients with only cardiovascular disease (p<0.001,95% CI: [1.12, 1.20],). Patients with only rheumatoid arthritis also had greater cholesterol and high density lipoprotein levels, but lower triglyceride levels.

Conclusion: Patients with rheumatoid arthritis without known cardiovascular disease do not undergo the same aggressive treatment to improve their lipid profile as patients with cardiovascular disease with or without rheumatoid arthritis. Healthcare profession

Author(s): Daniel Li, Alex Meara, Brian LaMoreaux, Guy Brock, Wael Jarjour