Background: Rheumatoid arthritis (RA) is a chronic inflammatory condition. Chronic inflammation is associated with atherosclerosis, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), chronic kidney disease. But sparse data are available regarding the trends of cardiovascular diseases and complications in RA. We conducted a National Inpatient Sample database analysis to demonstrate the trends of cardiac complications in patients with RA.
Methods: We used National Inpatient Sample data from 2005 to 2014 to identify admissions with the diagnosis of RA and identified who had associated cardiovascular complications also. The International Classification of Diseases-9th Revision-Clinical Modification codes were used for the diagnoses of RA; congestive heart failure (CHF), acute myocardial infarction (AMI), and atrial fibrillation (AF).
Results: A statistically significant increasing trend of AMI, CHF, and AF was found. Independent predictors of mortality in RA patients with AMI were age (OR 1.03, CI 1.02-1.04; P < 0.001), COPD (OR 1.67, CI 1.40-2.00; P < 0.001), cerebrovascular disease (OR 2.207, CI 1.71-2.86; P < 0.001), renal disease (OR 1.42, CI 1.16-1.75; P = 0.001), and alcohol abuse (OR 2.73, CI 1.73-4.32; P < 0.001). Independent predictors of mortality in RA patients with CHF were age (odds ratio [OR] 1.02, confidence interval [CI] 1.017-1.024; P < 0.001]), COPD (OR 1.09, CI 1.01-1.18; P = 0.023), cerebrovascular disease (OR 1.67, CI 1.44-1.95; P < 0.001), renal disease (OR 1.16, CI 1.07-1.27; P = 0.001). Independent predictors of mortality in RA patients with AF were age (OR 1.02, CI 1.02-1.03; P < 0.001), race (OR 1.16, CI 1.02-1.31; P = 0.022), COPD (OR 1.56, CI 1.42-1.71; P < 0.001), peripheral arterial disease (OR 1.34, CI 1.16-1.53; P < 0.001), cerebrovascular disease (OR 2.27, CI 1.0-2.58; P < 0.001), renal disease (OR 1.60, CI 1.44-1.80; P < 0.001). The mortality trend has increased significantly in the CHF (P = 0.025) and AF (P = 0.042) groups during this study period.
Conclusions: We have found a significant increase in trend of cardiovascular complications in RA patients. The proportion of patients, with cardiovascular comorbidities, have also been increased significantly.
Copyright © 2019 Elsevier Inc. All rights reserved.
Primary Causes of Hospitalizations and Procedures, Predictors of In-hospital Mortality, and Trends in Cardiovascular and Cerebrovascular Events Among Recreational Marijuana Users: A Five-year Nationwide Inpatient Assessment in the United States.Cureus. 2018 Aug 23;10(8):e3195. doi: 10.7759/cureus.3195. Cureus. 2018. PMID: 30402363 Free PMC article.
Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States.Cureus. 2017 Nov 3;9(11):e1816. doi: 10.7759/cureus.1816. Cureus. 2017. PMID: 29312837 Free PMC article.
Prevalence of chronic obstructive pulmonary disease (COPD) among rheumatoid arthritis: results from national inpatient database.J Community Hosp Intern Med Perspect. 2018 Aug 23;8(4):211-214. doi: 10.1080/20009666.2018.1485460. eCollection 2018. J Community Hosp Intern Med Perspect. 2018. PMID: 30181828 Free PMC article.
Significance of atrial fibrillation during acute myocardial infarction, and its current management: insights from the GUSTO-3 trial.Card Electrophysiol Rev. 2003 Sep;7(3):201-7. doi: 10.1023/B:CEPR.0000012382.81986.47. Card Electrophysiol Rev. 2003. PMID: 14739713 Review.
A systematic review of validated methods for identifying patients with rheumatoid arthritis using administrative or claims data.Vaccine. 2013 Dec 30;31 Suppl 10:K41-61. doi: 10.1016/j.vaccine.2013.03.075. Vaccine. 2013. PMID: 24331074 Review.