Cardiovascular mortality and cardiovascular event rates in patients with inflammatory rheumatic diseases in the CARdiovascular in rheuMAtology (CARMA) prospective study-results at 5 years of follow-up.
Por:
Martín-Martínez MA, Castañeda S, Sánchez-Alonso F, García-Gómez C, González-Juanatey C, Sánchez-Costa JT, Belmonte-López MA, Tornero-Molina J, Santos-Rey J, Sánchez González CO, Quesada E, Moreno-Gil MP, Cobo-Ibáñez T, Pinto-Tasnde JA, Babío-Herráez J, Bonilla G, Juan-Mas A, Manero-Ruiz FJ, Romera-Baurés M, Bachiller-Corral J, Chamizo-Carmona E, Uriarte-Ecenarro M, Barbadillo C, Fernández-Carballido C, Aurrecoechea E, Möller-Parrera I, Llorca J, González-Gay MA and CARMA Project Collaborative Group
Publicada:
18 jun 2021
Ahead of Print:
30 nov 2020
Resumen:
OBJECTIVES: To determine cardiovascular (CV) mortality and incidence of the first CV event (CVE) in patients with chronic inflammatory rheumatic diseases (CIRD) after 5 years of follow-up. METHODS: This is an analysis of the CARdiovascular in rheMAatology (CARMA) study after 5 years of follow-up. It includes patients with RA (n = 775), AS (n = 738) and PsA (n = 721), and individuals without CIRD (n = 677) attending outpatient rheumatology clinics from 67 public hospitals in Spain. Descriptive analyses were performed for the CV mortality at 5 years. The Systematic COronary Risk Evaluation (SCORE) function at 5 years was calculated to determine the expected risk of CV mortality. Poisson models were used to estimate the incidence rates of the first CVE. Hazard ratios of the risk factors involved in the development of the first CVE were evaluated using the Weibull proportional hazard model. RESULTS: Overall, 2382 subjects completed the follow-up visit at 5 years. Fifteen patients died due to CVE. CV deaths observed in the CIRD cohort were lower than that predicted by SCORE risk charts. The highest incidence rate of CVE [7.39 cases per 1000 person-years (95% CI 4.63, 11.18)] was found in PsA patients. However, after adjusting for age, sex and CV risk factors, AS was the inflammatory disease more commonly associated with CVE at 5 years [hazard ratio 4.60 (P =0.02)], compared with those without CIRD. CONCLUSIONS: Cardiovascular mortality in patients with CIRD at 5 years of follow-up is lower than estimated. Patients with AS have a higher risk of developing a first CVE after 5 years of follow-up.
Filiaciones:
Martín-Martínez MA:
Research Unit of Spanish Society of Rheumatology
Castañeda S:
Division of Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa
Cátedra UAM-ROCHE, EPID-Future, Universidad Autónoma de Madrid (UAM), Madrid
Sánchez-Alonso F:
Research Unit of Spanish Society of Rheumatology
García-Gómez C:
Division of Rheumatology, Consorci Sanitari de Terrassa, Terrassa, Barcelona
González-Juanatey C:
Division of Cardiology, Hospital Lucus Augusti, Lugo
Sánchez-Costa JT:
Research Unit of Spanish Society of Rheumatology
Belmonte-López MA:
Division of Rheumatology, Hospital General Carlos Haya, Málaga
Tornero-Molina J:
Division of Rheumatology, Hospital Universitario de Guadalajara, Guadalajara
Santos-Rey J:
Division of Rheumatology, Hospital Virgen de la Salud, Toledo
Sánchez González CO:
Division of Rheumatology, Hospital del Sureste, Madrid
Quesada E:
Division of Rheumatology, Hospital Universitario Vall D'Hebron, Barcelona
Moreno-Gil MP:
Division of Rheumatology, Complejo Hospitalario de Cáceres, Cáceres
Cobo-Ibáñez T:
Division of Rheumatology, Hospital Universitario Infanta Sofía, Madrid
Pinto-Tasnde JA:
Division of Rheumatology, Complejo Hospitalario Universitario A Coruña
Babío-Herráez J:
Division of Rheumatology, Hospital de Cabueñes, Asturias
Bonilla G:
Division of Rheumatology, Hospital Universitario de La Paz, Madrid
Juan-Mas A:
Division of Rheumatology, Hospital Sont Llatzer, Palma de Mallorca
Manero-Ruiz FJ:
Division of Rheumatology, Hospital Universitario Miguel Servet, Zaragoza
Romera-Baurés M:
Division of Rheumatology, Hospital Universitario de Bellvitge, Barcelona
Bachiller-Corral J:
Division of Rheumatology, Hospital Universitario Ramón y Cajal, Madrid
Chamizo-Carmona E:
Division of Rheumatology, Hospital de Mérida, Badajoz
Uriarte-Ecenarro M:
Division of Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa
Barbadillo C:
Division of Rheumatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid
:
Division of Rheumatology, Hospital General de Elda, Alicante
Aurrecoechea E:
Division of Rheumatology, Hospital U. Sierrallana, Torrelavega, Santander
Möller-Parrera I:
Division of Rheumatology, Instituto Poal, Barcelona
Llorca J:
Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria and CIBER Epidemiología y Salud Pública (CIBERESP)
González-Gay MA:
Division of Rheumatology, Hospital Universitario Marqués de Valdecilla
Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain
School of Physiology, Faculty of Health Sciences, Cardiovascular Pathophysiology and Genomics Research Unit, University of the Witwatersrand, South Africa
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