Risk of cardiovascular disease in Chinese patients with rheumatoid arthritis: a cross sectional study based on hospital medical records in 10 years

Zou, Kun; Xiao, Fu?Kun; Li, Hong?Ying; Zhou, Qiao; Ban, Lu; Yang, Min; Kuo, Chang-Fu; Zhang, Weiya

Abstract

Objective: Though the risk of cardiovascular disease (CVD) in rheumatoid arthritis (RA) has been established in Western population, little is known about the risk in Chinese people with RA. Our objective was to estimate the risk of CVD in Chinese people with RA using hospital medical records data.
Methods
The inpatients medical record database 2005‐2015 of Sichuan provincial people’s hospital was examined. All individuals with a primary diagnosis of RA were included as cases, and those of osteoarthritis (OA) were included as controls, which consisted of the unmatched dataset. Then, RA cases and OA controls were matched by sex and age at 1:1 ratio, forming the matched dataset. The morbidity of CVD (including ischemia heart disease (IHD), congestive heart failure (CHF), et al), stroke and arthrosclerosis were extracted from the database, so as the demographic data and comorbidities related to CVD. Multiple logistic regression analysis was used to estimate the risk of CVD in RA adjusted for demographics and comorbidities using the unmatched dataset. Sensitivity analysis was conducted 1) considering interaction terms between RA and comorbidities, and 2) using multivariable conditional logistic regression for the matched dataset.
Results: The unmatched data set comprised of 1824RA cases and 1995 OA controls and the matched dataset comprised of 1022 pairs of sex and age matched RA and OA patients. RA exhibited increased odds of prevalent CVD compared with OA, and the adjusted ORs (95%CIs) for CVD, stroke, IHD, CHF, and atherosclerosis were1.86(1.42‐2.43), 1.11(0.71‐1.74), 1.47(0.97‐2.24), 2.09(1.03‐4.22), and 2.49 (1.97‐3.13), respectively, and was 2.26 (1.29‐3.96) for IHD further adjusted for interaction term. The matched dataset analysis found similar results.
Conclusions: Chinese people with RA were approximated 2 times more 1 likely to have CVD, IHD, CHF and atherosclerosis compared with those with OA. The findings justified the need of further longitudinal study to establish the causal‐relationship between RA and CVD and to estimate the precise risk in this population.

Citation

Zou, K., Xiao, F., Li, H., Zhou, Q., Ban, L., Yang, M., Kuo, C.-F., & Zhang, W. (2017). Risk of cardiovascular disease in Chinese patients with rheumatoid arthritis: a cross sectional study based on hospital medical records in 10 years. PLoS ONE, 12(7), Article e0180376. https://doi.org/10.1371/journal.pone.0180376

• Journal Article Type: Article
• Acceptance Date: Jun 20, 2017
• Online Publication Date: Jul 5, 2017
• Publication Date: Jul 31, 2017
• Deposit Date: Jun 27, 2017
• Publicly Available Date: Aug 13, 2018
• Journal: PLoS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 7
• Article Number: e0180376
• DOI: https://doi.org/10.1371/journal.pone.0180376
• Keywords: rheumatoid arthritis, cardiovascular disease, risk, osteoarthritis, Chinese population
• Public URL: https://nottingham-repository.worktribe.com/output/867456
• Publisher URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180376
• Contract Date: Jun 27, 2017