OBJECTIVES : Rheumatoid arthritis (RA) is the most common chronic inflammatory arthritis in the United States. Despite remarkable strides in RA treatment, mortality remains high largely due to cardiovascular (CV) complications from the disease. Few studies adequately characterize CV event risk in the RA population. The purpose of this study is to determine the incidence of CV events and identify factors associated with CV event risk in RA patients within a Texas population.

METHODS : A retrospective cohort study was conducted using pharmacy and medical claims and electronic medical record data from July 1, 2010 through December 31, 2016. RA patients between 18 to 63 years of age and enrolled ≥6 months prior to and ≥6 months after first RA diagnosis (index date) were included in the study. A multivariate logistic regression model using age, gender, and pre-index CV event as covariates was used to predict CV event risk.

RESULTS : Of 1,385 patients included in the study, 1,103(79.6%) were female and mean(SD) age was 60(14.8) years. Incidence of CV events in a cohort of patients newly diagnosed with RA was 17.5%. After adjusting for age and gender, patients with a history of a prior CV event were significantly more likely to experience a CV event (OR 4.2; 95%CI: 1.8-9.4). Age was significantly associated with higher CV event risk (OR: 1.1; 95%CI: 1.1-1.11). Female gender was not significantly associated with higher CV event risk (OR: 0.71; 95%CI: 0.5-1.0).

CONCLUSIONS : Previous published data have shown that RA increases CV event risk by 48% compared to the general population. Our results show that prior CV event risk increases risk of future CV events by four-fold in the RA population. Future studies will focus on exploring other measures such as adherence to therapy, glucocorticoid utilization, and laboratory values to determine their effects on the increase CV risk in RA patients.