Ten-year risk of cardiovascular disease high in newly diagnosed RA patients

The 10-year absolute CV risk in RA patients is high, even at incidence, and is similar to that in non-RA subjects 5-10 years older, new research claims. These findings underscore the importance of careful CV risk assessment for each newly diagnosed RA patient, followed by individualized preventive care, the researchers conclude. To estimate the 10-year absolute risk of cardiovascular (CV) events in newly diagnosed rheumatoid arthritis (RA) patients the researchers compared a cohort of RA patients (n=553) (defined according to the American College of Rheumatology 1987 criteria) with an age- and sex-matched non-RA cohort (n=574). They collected data on CV risk factors and CV events. Cox regression models were used to estimate the 10-year risk of a combined CV end point, adjusting for CV risk factors. Subjects were classified into 5 risk categories based on their 10-year absolute risk. The average follow-up time was 14.7 years for RA patients and 16.1 years for non-RA subjects. The absolute CV risk in RA patients was similar to that in non-RA subjects who were 5-10 years older and varied substantially according to the presence of CV risk factors, the researchers reported. The 10-year absolute CV risk among 60-69-year-old RA patients with no risk factors was 16.8%, but rose to 60.4% if risk factors such as smoking, hypertension, dyslipidemia, diabetes, and obesity were present. Among RA patients with a low body mass index, in addition to the above risk factors, the 10-year absolute CV risk rose to 86.2%.   “Our findings indicate that CV risk is high even in newly diagnosed RA patients, and emphasize the need for early efforts to undertake CV risk detection and prevention in RA patients,” the researchers concluded. Ironically, they noted, the need for early intervention for the detection and prevention of CVD in RA patients is analogous to the concept of a therapeutic window of opportunity for the reduction of joint damage in RA patients....