Abstract
ObjectivesTo study risk for cardiovascular disease (CVD) in Japanese patients with rheumatoid arthritis (RA).MethodsWe used a Medical Data Vision database mainly composed of health insurance claim data and diagnosis-procedure combination data from Japan. Patients with RA diagnosed from April 2011 to March 2014 at 71 hospitals were identified with the International Classification of Diseases 10th revision (ICD-10) and history of anti-RA drug prescription. Hospitalizations for CVD including ischemic heart disease, heart failure, and stroke were identified by a combination of diagnosis (ICD-10) and diagnostic procedures. CVD incidence rate ratio (IRR) for RA versus osteoarthritis was calculated. Risk factors were analyzed using univariate and multivariate Cox proportional hazard models with baseline C-reactive protein (CRP) and traditional risk factors as covariates.ResultsWe identified 8658 patients with RA. The age–sex adjusted IRR for RA versus osteoarthritis was high for total CVD [2.12; 95 % confidence interval (CI) 1.93–2.32], ischemic heart disease (2.16; 95 % CI 1.86–2.50), heart failure (2.34; 95 % CI 2.07–2.65), and stroke (1.68; 95 % CI 1.41–2.00). Risk factor analysis showed a tendency for cardiovascular risk to increase with higher baseline CRP, although the difference was not statistically significant (hazard ratio 1.43; 95 % CI 0.99–2.07).ConclusionOur study indicates an increased risk for CVD and an association between systemic inflammation and CVD in Japanese RA patients.
Highlights
Rheumatoid arthritis (RA) is a chronic disease with various complications and a higher mortality than that expected in the general population (Pincus et al 1994)
Sakai et al (2016) reported high prevalence of cardiovascular comorbidities in patients with RA, using a database of medical claims from employment-based health insurance organizations in Japan. We used another healthcare database of diagnosis-procedure combination data, health insurance claims data, and laboratory data from hospitals located throughout Japan to study the relative risk of Cardiovascular disease (CVD) as well as the association between systemic inflammation and CVD in Japanese patients with RA
In the RA cohort (n = 8658), the age-sex adjusted incidence rate ratio (IRR) for RA versus OA were statistically high for total CVD (2.12; 95 % confidence interval (CI) 1.93–2.32), ischemic heart disease (2.16; 95 % CI 1.86–2.50), myocardial infarction
Summary
Rheumatoid arthritis (RA) is a chronic disease with various complications and a higher mortality than that expected in the general population (Pincus et al 1994). Cardiovascular disease (CVD) is one of the serious complications in RA and is a major cause of death in RA patients in both the West and Japan (Sihvonen et al 2004; Nakajima et al 2010). Sakai et al (2016) reported high prevalence of cardiovascular comorbidities in patients with RA, using a database of medical claims from employment-based health insurance organizations in Japan. We used another healthcare database of diagnosis-procedure combination data, health insurance claims data, and laboratory data from hospitals located throughout Japan to study the relative risk of CVD as well as the association between systemic inflammation and CVD in Japanese patients with RA. OA shares with RA both traditional and lifestyle risk factors for CVD (Pelletier et al 2001)
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