Abstract 12100: Association Between Rheumatoid Arthritis and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Abstract

Background: Rheumatoid arthritis (RA) is an autoimmune disorder with a varying range of organs involved and leading to adverse outcomes. However, very little is known, with conflicting results about the association between RA and atrial fibrillation (AF) and the incidence of acute coronary syndrome (ACS). Objective: We aim to evaluate the incidence of atrial fibrillation (AF), ACS, and other clinical outcomes among RA patients. Methods: We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until 10th April 2023. Primary clinical outcomes were AF. Secondary endpoints were acute coronary syndrome (ACS), stroke, and all-cause of mortality. Results: A total of 4,667,199 patients were included in the analysis, with 77460 (xy%) patients in the RA group and 4589739 patients in the NRA group. The most common Comorbidity includes hypertension among RA and NRA groups (27% vs. 6%), respectively. Pooled analysis of primary outcomes shows that RA groups of patients had significantly higher odds AF (OR, 1.17(95%CI: 1.11-1.23), P<0.00001, I2=34%) compared with NRA groups. Secondary Outcomes shows that the RA group of patients had significantly higher odds of ACS (OR, 1.37(95%CI: 1.23-1.53), P<0.00001) compared with the NRA groups. However, the likelihood of stroke (OR, 1.02(95%CI: 0.95-1.08), P=0.65), and all cause mortality (OR, 1.25(95%CI: 0.84-1.87), P=0.27, I2=91%) was comparable between both the groups of patients. Conclusion: Our study shows that RA groups of patients are at increased risk of having atrial fibrillation and acute coronary syndrome. However, mortality risk was comparable between both groups.