Rheumatology

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Cardiovascular morbidity and mortality remain similar in two cohorts of patients with long-standing rheumatoid arthritis seen in 1978 and 1995 in Malmö, Sweden
Rheumatology, 10/29/09

Bergström U et al. – Patients with RA have an increased risk of cardiovascular disease. Management of RA has changed substantially over time. The aim of this study was to evaluate changes in cardiovascular morbidity and mortality over the period of 1978–2002. There were similar elevations in the incidence of cardiovascular comorbidity in RA patients, identified two decades apart compared with the general population, in spite of more extensive treatment and reduced disease severity in the more recent cohort.

• 2 cohorts of consecutive RA patients seen at outpatient clinics in Malmö, Sweden, were started in 1978 (n = 148) and 1995 (n = 161) and compared with corresponding background population
• Patients followed for 8 years, and fatal and non-fatal cardiovascular first events identified using 2 national registers, hospital discharge and cause of death
• Standardized morbidity ratio (SMoR) and standardized mortality ratio (SMR), adjusted for age and sex calculated

• Sex distribution, age at disease onset and disease duration similar in both groups
• 1995 cohort more extensively treated with DMARDs and had less disease activity and disability
• Total cardiovascular morbidity increased in 1978 cohort as well as in 1995 cohort
• This was mainly due to increased risk of CAD
• Overall mortality elevated in 1978 cohort but not in 1995 cohort
• No change in cardiovascular excess mortality

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