TY - JOUR
T1 - Subcutaneous nodules are associated with cardiovascular events in patients with rheumatoid arthritis
T2 - results from a large US registry
AU - Kaushik, Prashant
AU - Solomon, Daniel H.
AU - Greenberg, Jeffrey D.
AU - Anderson, James T.
AU - Reed, George
AU - Pala, Ozlem
AU - Sumbul-Yuksel, Bahar
AU - Kadam, Pooja
AU - Kremer, Joel M.
PY - 2015/10/26
Y1 - 2015/10/26
N2 - Subcutaneous nodules are the most common conspicuous extra-articular manifestation of rheumatoid arthritis (RA). Cardiovascular disease (CVD) is the leading cause of death in patients with RA. The objective of this study is to examine the possibility of a relationship between subcutaneous nodules and “first ever” cardiovascular disease event, i.e., myocardial infarction (MI), stroke, or cardiovascular death in a large registry-cohort of patients with RA. Patient information was collected from the CORRONA registry from October 2001 to September 2011. A total of 26,042 patients with RA were studied for the presence or absence of subcutaneous nodules. Cox proportional hazards regression models were constructed to estimate the hazard ratios (HR) for CVD events in relation to subcutaneous nodules at baseline. Three statistical models were used to examine the association between subcutaneous nodules and CVD: Model A adjusted for age and sex associated risk, model B adjusted for traditional CV risk factors, and model C adjusted for factors in models A and B plus underlying RA-specific measures. The definition of primary exposure was “subcutaneous nodules at baseline.” A total of 3908 patients had subcutaneous nodules at baseline. Of the 566 total composite CVD events, 138 occurred in the group that had SCN at baseline. Incidence rate-ratio values (patients with subcutaneous nodules at baseline vs. no subcutaneous nodules at baseline) for composite CVD events, MI, stroke, and cardiovascular death were 1.55, 1.65, 1.37, and 1.68, respectively. Adjusted HR values (95 % CI) for composite CVD events based on “subcutaneous nodules-status at baseline” (primary exposure) were as follows: 1.35 (1.11–1.63) for model A, 1.25 (1.03–1.52) for model B, and 1.03 (0.831–1.277) for model C. Subcutaneous nodules were associated with increased CVD events in RA. This association persisted after adjusting for age, sex, and traditional CV risk factors.
AB - Subcutaneous nodules are the most common conspicuous extra-articular manifestation of rheumatoid arthritis (RA). Cardiovascular disease (CVD) is the leading cause of death in patients with RA. The objective of this study is to examine the possibility of a relationship between subcutaneous nodules and “first ever” cardiovascular disease event, i.e., myocardial infarction (MI), stroke, or cardiovascular death in a large registry-cohort of patients with RA. Patient information was collected from the CORRONA registry from October 2001 to September 2011. A total of 26,042 patients with RA were studied for the presence or absence of subcutaneous nodules. Cox proportional hazards regression models were constructed to estimate the hazard ratios (HR) for CVD events in relation to subcutaneous nodules at baseline. Three statistical models were used to examine the association between subcutaneous nodules and CVD: Model A adjusted for age and sex associated risk, model B adjusted for traditional CV risk factors, and model C adjusted for factors in models A and B plus underlying RA-specific measures. The definition of primary exposure was “subcutaneous nodules at baseline.” A total of 3908 patients had subcutaneous nodules at baseline. Of the 566 total composite CVD events, 138 occurred in the group that had SCN at baseline. Incidence rate-ratio values (patients with subcutaneous nodules at baseline vs. no subcutaneous nodules at baseline) for composite CVD events, MI, stroke, and cardiovascular death were 1.55, 1.65, 1.37, and 1.68, respectively. Adjusted HR values (95 % CI) for composite CVD events based on “subcutaneous nodules-status at baseline” (primary exposure) were as follows: 1.35 (1.11–1.63) for model A, 1.25 (1.03–1.52) for model B, and 1.03 (0.831–1.277) for model C. Subcutaneous nodules were associated with increased CVD events in RA. This association persisted after adjusting for age, sex, and traditional CV risk factors.
KW - Cardiovascular disease events
KW - Rheumatoid arthritis
KW - Subcutaneous nodules
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U2 - 10.1007/s10067-015-3032-9
DO - 10.1007/s10067-015-3032-9
M3 - Article
C2 - 26242470
AN - SCOPUS:84942310411
VL - 34
SP - 1697
EP - 1704
JO - Clinical Rheumatology
JF - Clinical Rheumatology
SN - 0770-3198
IS - 10
ER -